Patnaik Sanjeev, Nayak Biswaranjan, Sahoo Akshaya Kumar, Sahu Nabin Kumar
Department of Orthopaedics, Apollo Hospital, Bhubaneswar, Odisha, India.
J Orthop Case Rep. 2017 Mar-Apr;7(2):3-6. doi: 10.13107/jocr.2250-0685.722.
Total hip replacement (THR) is a highly successful operation in alleviating pain and improving the overall function of the hip, in end-stage arthritis of the hip, in otherwise fit patients. However, THR as a surgical option in post-traumatic hip arthritis with ipsilateral above-knee amputation is rarely reported.
We are presenting a case report of a 30-year-old male, who had previously underwent an above-knee amputation due to road-traffic accident, presenting 24 h after the injury with segmental fracture femur and popliteal artery laceration, for which the limb could not be salvaged. He had an impacted anteroinferior dislocation of the ipsilateral hip with significant cartilage damage of the femoral head which required open reduction. Subsequently, he developed traumatic arthritis of the involved hip which required conversion to an uncemented THR, using a minimally invasive (MIS) anterolateral approach. The preoperative management, surgical technique, and postoperative rehabilitation are described to highlight the technical challenges, these lower limb amputees may present along with review of literature of such rare cases.
THR in an above-knee amputee with posttraumatic hip arthritis using MIS technique is an encouraging surgical option for early functional recovery and minimizing surgical complications.
全髋关节置换术（THR）对于缓解晚期髋关节关节炎且身体状况良好的患者的疼痛并改善髋关节整体功能而言，是一项非常成功的手术。然而，作为创伤后髋关节关节炎合并同侧膝上截肢患者的手术选择，全髋关节置换术鲜有报道。
我们报告一例30岁男性患者，该患者此前因道路交通事故接受了膝上截肢手术，受伤24小时后出现股骨干骨折和腘动脉撕裂伤，肢体无法挽救。他同侧髋关节存在嵌顿性前下脱位，股骨头软骨严重受损，需要切开复位。随后，他出现了受累髋关节的创伤性关节炎，需要采用微创（MIS）前外侧入路转换为非骨水泥型全髋关节置换术。描述了术前管理、手术技术和术后康复情况，以突出这些下肢截肢患者可能面临的技术挑战，并回顾此类罕见病例的文献。
采用MIS技术对创伤后髋关节关节炎的膝上截肢患者进行全髋关节置换术，是促进早期功能恢复并将手术并发症降至最低的一项令人鼓舞的手术选择。
