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All Journal The Hip and Knee Journal
Afrian, Jifaldi
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Biochemistry, Genetics & Molecular Biology Decision Sciences, Operations Research & Management Education Health Professions Neuroscience

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Management of Secondary Osteoarthritis with Proximal Femoral Deformity due to Previous Coxitis Hip: A Case Report Renaldi, Rizal; Afrian, Jifaldi; Chilmi, Mohammad Zaim
The Hip and Knee Journal Vol 4, No 1 (2023): February
Publisher : Indonesian Hip and Knee Society (IHKS)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (6749.867 KB) | DOI: 10.46355/hipknee.v4i1.109

Abstract

Most proximal femoral deformities encountered during hip arthroplasty are secondary to degenerative processes, previous osteotomy, or fracture and could be a challenged for surgeons. Femoral deformity may be angular, rotational, or one of bone diameter or length. Fully understanding the anatomy of the deformity is the first element in deciding how to best treat the deformity during Total Hip Arthroplasty (THA). Female 31 years old complaint of pain on her left hip with restricted motion, with a leg length discrepancy (LLD) of 2 cm and a history of operation due to left hip infection when she was a baby. THA was performed with carefully evaluating the abductor muscle to maintain hip stability. Postoperatively the patient has an equal leg length, with less pain on the hip, a good ROM, and able to walk dependently using a cane. Slight tightness on the abductor and adductor muscle was noted postoperatively and the patient undergone physiotherapy. Multiple important factor must be considered before considering THA in patients with proximal femoral deformity, including abductor function, osseous anatomy, hip stability and LLD. One must be careful of correction of LLD greater than 3 cm because possible effect on abductor strength, hip stability and sciatic nerve function. In this case, we demonstrated that a successful THA can be achieved despite altered anatomy due to secondary developmental changes. In the setting of sufficient abductor strength and bony stock amenable to implant fixation, THA is a viable option for management and careful preoperative planning helps predict prosthesis requirements and technical challenges.
Total Hip Replacement For Ankylosed Hip: A Case Report Pratama, Rahendra; Afrian, Jifaldi; Chilmi, Mohammad Zaim
The Hip and Knee Journal Vol 3, No 2 (2022): August
Publisher : Indonesian Hip and Knee Society (IHKS)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.46355/hipknee.v3i2.107

Abstract

AbstractIntoductionAnkylosis of the hip is very difficult to treat surgically and should only be attempted by an experienced surgeon together with comprehensive pre-operative planning. It is important to inform the patient about the possible complications of this procedure.Case DescriptionMale  patient  at the age of 68 years with severe left hip pain for the last 30 years. The pain was intermittent,mostly at night, The pain got worse during walk and subside when resting. No history of trauma, TB contact, fever, allergies, alcohol usage or smoking. There was also no history of surgery. X-Ray shows fusion of the left hip. Blood test shows no infection detected.DiscussionPosterior approach  was used in this case, inability to internally rotate the hip due to bony fusion will made the osteotomy more difficult. Visualized Greater Trochanter and palpable Lesser trochanter as landmark for osteotomyConclusionTHA is an effective treatment for severe flexion ankylosed/fused hip deformity although there are high surgical complications than routine hip arthroplasties. Adequate preoperative planning will improve the clinical outcome of the  hips.
Co-Authors Mohammad Zaim Chilmi Pratama, Rahendra Renaldi, Rizal