Solichin Iman, Putera Guntur Utama, Kuncoro Mohamad Walid
Department of Orthopaedic and Traumatology, Faculty of Medicine Universitas Indonesia, Orthopaedic Hospital Purwokerto, Indonesia.
Department of Orthopaedic and Traumatology, Faculty of Medicine Universitas Indonesia, Dr. Cipto Mangunkusumo National Central General Hospital, Indonesia.
Int J Surg Case Rep. 2022 Apr;93:106861. doi: 10.1016/j.ijscr.2022.106861. Epub 2022 Feb 25.
Resection arthroplasty of the hip was already performed for recent 100 years. This kind of surgery has been used for a wide variety of hip problems such as infection, degenerative osteoarthritis and prosthetic joint infection. Total hip replacement is remarkable procedure in order to relieve pain and restore hip function. We present this report to describe our experience in treating hip infection by used two stages of surgery.
A 61-years old male suffered left hip infection that leads severe destruction on his joint. He felt badly pain on his hip with significant disability associated it such as limping, restriction of movements, and shortening of the limb. The hip movements were painful and caused walking in antalgic gait. Radiologic examination at that time revealed gross destruction of femoral head as well as acetabulum, irregular and hazy joint margins with diminished joint space. Patient was diagnosed with chronic non-specific inflammation of the hip joint.
Two stages surgery were performed on this patient. Resection arthroplasty firstly performed in order to eradicate the infection completely and alleviate very bothersome pain for improvement of patient's quality of life. Two years later, after patient was ready for next stage mentally, cemented total hip replacement performed to achieve normal function of the hip. Five-years follow up functional outcome was performed. Patient was very satisfied with the result with Harris hip scores was 95.
Resection arthroplasty of the hip followed by a conversion to total hip replacement in hip infection case provide complete infection eradication, good functional outcome and satisfaction for the patient. Although the procedure was time-consuming it can be a choice if the eradication of infection still in a doubt.
髋关节切除成形术已经开展了近100年。这种手术已被用于多种髋关节问题，如感染、退行性骨关节炎和人工关节感染。全髋关节置换术是缓解疼痛和恢复髋关节功能的显著手术。我们撰写本报告以描述我们采用两阶段手术治疗髋关节感染的经验。
一名61岁男性患有左髋关节感染，导致其关节严重破坏。他感到髋关节剧痛，并伴有严重残疾，如跛行、活动受限和肢体缩短。髋关节活动时疼痛，导致患者呈疼痛性步态行走。当时的放射学检查显示股骨头和髋臼严重破坏，关节边缘不规则且模糊，关节间隙变窄。患者被诊断为髋关节慢性非特异性炎症。
对该患者进行了两阶段手术。首先进行切除成形术以彻底根除感染，并缓解非常困扰人的疼痛，从而改善患者的生活质量。两年后，在患者心理上准备好进行下一阶段手术时，进行了骨水泥型全髋关节置换术以实现髋关节的正常功能。进行了五年的随访功能评估。患者对结果非常满意，Harris髋关节评分95分。
在髋关节感染病例中，先进行髋关节切除成形术，然后转换为全髋关节置换术，可彻底根除感染，获得良好的功能结果并让患者满意。尽管该手术耗时，但如果感染的根除仍存在疑问，它可以是一种选择。
