Hip
Total Hip replacement
Management of a hip dysplasia in a middle-aged woman
In this clinical case, a 60-year-old woman presents with severe hip pain for the past year and a limp. The objectives of this case are to discuss the classifications and therapeutic options for hip dysplasia in a middle-aged patient.
Milan, ITALY
Gaetano Pini Orthopaedic Institute
Milan, ITALY
Gaetano Pini Orthopaedic Institute
Part one
Clinical presentation
- 60 year old lady
- 2 pregnancies
- Hypercholesterolemia
- High blood pressure
- Obesity I degree
- Deny allergies
- Shortening right limb
- Limping
- Severe right hip pain since 1 year
Pre-operative X-rays and CT-scan
Part two
How would you grade this dysplasia?
- ✔️Crowe IV
How would you manage this condition?
- ✔️Hip replacement with Subtrochanteric osteotomy
What are the rules to respect in this kind of surgery?
- ✔️Restoration of the hip center
- ✔️Leg-length equalization
Final strategy decision
In this case, a total hip replacement was done through an extended anterior approach. A dual mobility cup was impacted in the true acetabulum and a subtrochanteric osteotomy, fixed with a LCP small foot plate, was performed in order to restore the lower limb length reducing the risk of nerve injury. Psoas and adductor tenonotmy was also performed.
Surgical procedure images
video
Post-operative X-rays
Clinical aspect at 8 months
