This poster was originally presented at the ESSR 2012 meeting, June 28-30, in Innsbruck/AT.
www.essr.org
Keywords:
Prostheses, Hyperplasia / Hypertrophy, Genetic defects, Surgery, Conventional radiography, Musculoskeletal system, Bones
Authors:
E. M. McGuire, I. Alcelik, A. Bhaskaran, S. Allcock; Whitehaven/UK
DOI:
10.1594/essr2012/P-0079
Results
We present a right cemented Charnley total hip replacement for osteoarthritis in a 55 year old patient with Engelmann’s disease.
A literature research revealed that there were no previous cases of this nature in the literature and adequate pre-operative planning was therefore performed with a thorough discussion with the patient.
Pre-operative x-rays (figures 1-9) demonstrated deformities of the long bones typical of Camurati-Engelmann's disease; marked diaphyseal cortical thickening resulting in uneven increased diameter and some narrowing of medullary canal.
There is osteoarthritis of the hip and knee.
There is minor spondylosis present with a scoliosis.
A small femoral head and solid femoral neck with a marble-like texture were noted intra-operatively.
There was complete obliteration of the medullary canal for approximately an inch in the calcar region.
A small flanged prosthesis was cemented in the usual way. During attempted entering of the femoral canal,
despite adequate capsular release,
there was a fracture extending three inches distally but sparing the calcar. This was mainly posteriorly. A ten inch round back femoral component was therefore cemented. Leg lengths were equal with minimal distraction and a circlage wire was applied,
avoiding the sciatic nerve,
close to bone. Appearances were satisfactory.
The patient made a full functional recovery.