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  • Chronic abductor lesion after total hip arthroplasty in a sitting proud stem: direct repair by osteotomy of the greater trochanter

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Case Reports: Novel treatment (new drug/interventions; established drug/procedure in new situation)
Chronic abductor lesion after total hip arthroplasty in a sitting proud stem: direct repair by osteotomy of the greater trochanter
  1. Leonardo Tassinari1,2,
  2. Giuseppe Geraci1,2,
  3. Alberto Di Martino1,2 and
  4. Cesare Faldini1,2
  1. 1Clinica ortopedica e traumatologica, IRCCS - Istituto Ortopedico Rizzoli di Bologna, Bologna, Italy
  2. 2Dipartimento di Scienze Biomediche e Neuromotorie, Università di Bologna, Bologna, Italy
  1. Correspondence to Dr Leonardo Tassinari; leonardo.tassinari{at}ior.it

Abstract

A woman in her late 70s with bilateral total hip arthroplasty (THA) presented with left hip pain arising immediately after the last THA procedure, progressively worsening. Clinically, a severe abductor insufficiency with Trendelenburg limp was observed. Moreover, symptomatic leg length discrepancy required a contralateral heel lift of 0.5 cm. She was previously managed conservatively without any clinical benefit. Radiographs showed a well-fixed uncemented straight, sitting proud stem. MRI showed a large abductor tear. A minimally invasive proximal advancement of the greater trochanter was planned to allow direct surgical repair of the abductor lesion. The patient made a good recovery, and 12 months after surgery, wire removal was performed. The patient gained significant improvements in hip function (Harris Hip Score from 52 to 89), full limp recovery and complete pain relief at 13 months follow-up from primary surgery.

  • Hip implants
  • Hip prosthesis implantation
  • Prosthesis failure
  • Orthopaedics

https://doi.org/10.1136/bcr-2022-253857

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    Footnotes

    • Contributors CF conceived the idea of the presented case. LT and GG have collected data and wrote the manuscript. ACDM and CF contributed to the final version of the manuscript. All authors provided critical feedback and helped shape the discussion.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.