Total hip arthroplasty in paralytic dislocation from poliomyelitis.
This article presents a case of a patient with degenerative hip disease in paralytic dislocation by poliomyelitis. Poliomyelitis is an acute infection disease caused by a group of neurotrophic viruses, which has a special affinity by the anterior horns cells of the spinal cord and for certain motor nuclei of the brain stem. Paralysis is a flaccid type and characteristically paralysis is asymmetrical. It is said that the joints of the affected limb by poliomyelitis are protected from the development of osteoarthritis. Hip dislocation in poliomyelitis is an acquired deformity caused by flaccid paralysis and the resulting muscular imbalance. In young children, when the gluteus maximus and medius muscles are paralyzed and the hip flexors and adductors are of normal strength, eventual luxation of the hip is almost inevitable. Hip osteoarthritis in a limb with poliomyelitis is an unusual entity because these limbs do not support excessive loads. In patients who present with the residual effects of poliomyelitis including degenerative disease and hip dysplastic, surgery is one of the most difficult challenges faced by reconstructive surgeons. In such cases, surgeons should attempt to optimize the component position and choice, surgical approach, and soft tissue tensioning because stability of the prosthesis can be problematic.
Laguna
Rafael
R
Department of Orthopedic Surgery, Gregorio Marañon University Hospital, Madrid, Spain.
Barrientos
Jesús
J
D000328:Adult; D019644:Arthroplasty, Replacement, Hip / Q000295:instrumentation / Q000379:methods; D005260:Female; D006621:Hip Joint / Q000601:surgery*; D006622:Hip Prosthesis; D006801:Humans; D004204:Joint Dislocations / Q000209:etiology* / Q000601:surgery*; D010243:Paralysis / Q000209:etiology* / Q000601:surgery*; D011051:Poliomyelitis / Q000150:complications* / Q000601:surgery*; D016896:Treatment Outcome