ABSTRACT
BACKGROUND: Secondary hip osteoarthritis with acetabular bone defect is still a challenging case in hip arthroplasty surgery. The incidence of revision total hip arthroplasty is estimated to be between 10% and 15% in 10 years. Simple revision cementless acetabular cup after a prior complex cemented-THA rarely performed. CASE PRESENTATION: A case of aseptic loosening with prosthesis dislocation after THA was reported in a 54 year-old female patient. The patient had prior surgery of THA 10 years ago due to secondary post-traumatic hip osteoarthritis with acetabular bone defect. At the first surgery, cemented acetabular cup with acetabular bone grafting was performed to fill the defect. A complete new acetabulum bone formation was encountered at 10 years after the surgery which lead to simple revision THA with primary cementless acetabular cup. Excellent functional outcome was also reported at the final follow-up after revision THA. CONCLUSION: This case showed that the potential of bone healing of the acetabulum cannot be underestimated. Therefore, it is suggested to always put an adequate bone graft to manage acetabular bone defect in THA surgery and a new acetabulum bone formation can be expected.
ABSTRACT
BACKGROUND: The distraction osteogenesis procedure has a high potential to treat bone defect problems. The alternative technique to treat nonunion associated with a bone defect is the acute shortening and re-lengthening (ASRL) procedure. This study aimed to evaluate the outcome of ASRL procedure with a monorail fixator to treat femur/tibia nonunion associated with the bone defect. METHOD: Retrospective analysis was performed to patients who received ASRL procedure with monorail fixator for femur or tibia nonunion from October 2018 to October 2020 at Prof. Dr. R. Soeharso Orthopaedic hospital. One case was loss to follow-up and excluded from the study. The rest of 16 cases were included for further analysis. The evaluation was performed to the demographic, intraoperative procedure, problems/complications, additional procedure, and final outcome. RESULTS: There were 13 male and three female patients with age ranged from 16 to 64 years old. The follow-up period ranges 9-31 months. ASRL procedures performed to 6 femur and 10 tibias. The problems/complications: two cases with problems associated with callus formation, two cases of fracture at corticotomy site, one case of skin necrosis, one case of osteomyelitis, one case of malrotation. Additional surgical procedures were needed 5/16 (31.2%) cases. Evaluation at the final follow-up period showed 14/16 (87.5%) cases had a complete bone union. CONCLUSIONS: Acute shortening and re-lengthening (ASRL) could be reliable as a method of treatment for femur/tibia nonunion associated with the bone defect. Several possible complications need to be considered prior to perform this procedure.
ABSTRACT
INTRODUCTION AND IMPORTANCE: Limb length discrepancy can be occurred as residual problems after bone cyst treatment. Distraction osteogenesis is one of surgical option to treat this problem. CASE PRESENTATION: A male 27 years old came with 3 cm residual lower limb discrepancy after treatment of femoral aneurismal bone cyst (ABC). Distraction osteogenesis has been successfully performed to treat this case at the site of previously cystic bone lesion. CONCLUSION: Good quality of callus could be expected at the site of distraction osteogenesis that previously a cystic bone lesion.
