Management of a severe bone loss in a patient with hip resurfacing

Hip
Resurfacing
Revision Arthroplasty
Management of a severe bone loss in a patient with hip resurfacing

This clinical case aims to explore the evolution of hip resurfacing techniques and the approach to revision surgery in the context of major bone loss, illustrated by the case of a 56-year-old man with a history of bilateral hip resurfacing, presenting with suspected occupational chromium poisoning.

Nicolas Reina
CHU Toulouse, FRANCE
Course Director

Professor Reina is Head of Hip and Trauma department, of the University Hospital in Toulouse, France. He holds a PhD in Anthropobiology. He completed a fellowship in Oxford, UK and worked in Mayo Clinic, Rochester for research.

His main focus is hip & pelvis surgery. His clinical practice comprises conservative surgery, primary and complex revision total hip arthroplasty as well as trauma for complex acetabular fractures.

Board member of French Hip Knee Surgery, he is also member of the European Hip Society and the International Board of the American Association of Hip Knee Surgeons. He published more than 150 peer reviewed publications and book chapters, and lectured in various international conferences. His research interests integrate big data in orthopedics, modern care in hip surgery such as minimally invasive techniques, and musculoskeletal system’s ability to adapt to its environment (biomechanics and anthropological variability).

Part one
Clinical presentation
  • 56 Y.O male
  • Bilateral hip resurfacing (right side 2011, left side 2012)
  • Completely asymptomatic, was still skiing last winter
  • Referred because of a suspicion of professional chromium intoxication based on urine biology results
  • On physical examination, he doesn’t complain of pain, and shows normal hip mobility

Imagery

Severe bone loss in a patient with hip resurfacing: X-Ray 2012
X-Ray 2012
Severe bone loss in a patient with hip resurfacing: X-Ray 2024
X-Ray 2024
CT scan
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