Clinical Results of Total Hip Arthroplasty in Two Patients with Charcot Hip Joints due to Congenital Insensivity to Pain with Anhydrosis

Abstract

Traditionally, Charcot arthropathy has been considered an absolute contraindication for total hip arthroplasty (THA). However, some recent reports have shown that good short- to mid-term results can be achieved by improving the durability of the implant. This paper reports the mid- to long-term results of THA in two patients with Charcot hip joints caused by congenital insensivity to pain with anhydrosis. Both patients suffered multiple posterior dislocations in the six months immediately following surgery. However, with the continuous use of a hard abduction brace, one patient was eventually able to walk with a lofstrand cane and the other with the use of one crutch. Although one patient experienced a dislocation five years after surgery, X-rays taken after nine years and five years, respectively, revealed no clinical signs of implant loosening. We conclude that, with careful planning and appropriate precautions, THA may be a viable treatment option for Charcot hip joints caused by congenital insensivity to pain with anhydrosis.

Total Hip Arthroplasty in Patients With Neurological Conditions: A Systematic Review

“…Charcot or neuropathic arthropathy occurs in patients with reduced sensory and nociceptive feedback in a joint susceptible to repetitive microtrauma, leading to progressive joint destruction and deformity [ 65 ]. Five studies met our inclusion criteria which reported upon THA outcomes in the neuropathic or “Charcot” hip population [ [65] , [66] , [67] , [68] , [69] ].…”