: Perioperative acute arterial complications occur rarely after total hip arthroplasty THA but can be limb or life threatening. Here, we report a case of an arterial thrombosis after primary THA for an arthrodesed hip. The arterial occlusion occurred because of the surgical mobilization against the immovable exion and adduction position. A review of the literature on vascular complications arising after THA suggests multiple possible mechanisms and clinical presentations that relate to these complications. Specific risk factors can be identified in THAs replacement cases and THA for the arthrodesed hip can be a major risk factor. Most of these vascular complications can be prevented or more efficiently treated by thorough preoperative assessment and careful postoperative monitoring.
A severe abrasion occurred at the stem taper 13 years after total hip arthroplasty. The bearing couple was 28 mm ceramic on polyethylene. The ceramic head had almost no damage, whereas the stem taper had severe damage. An ectopic bone probably contributed to the abrasion. The ectopic bone had grown to restrict the normal motion in the bearing couple and all stress and torque seemed to concentrate in the junction until the junction obtained mobility instead of the original bearing couple.
: Rapidly destructive coxarthropathy RDC is a clinical concept propounded by Postel and Kerboull. RDC is characterized by joint destruction progression within a year, although the etiology of this disorder remains unknown. We evaluated 21 hips in 20 patients radiologically diagnosed with RDC. All patients underwent a total hip arthroplasty. The average age at surgery was 75 years. The affected side was more osteoporotic in all patients, and the pelvic angle, which indicates the spinopelvic alignment, was distributed below the normal range, i.e., the posterior tilt was more than the normal range. The affected side showed a higher center-edge CE angle and anterior-acetabular head index AAHI than the unaffected side, possibly due to severe head collapse. Our result supported that osteoporosis and / or mechanical factors in uence the course of RDC. More investigations such as biochemical and immunopathological analyses would be necessary to clarify the etiology of RDC, which could be a terminal stage of some lesions.
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