Modular bipolar prosthesis and total hip replacement in a case of bilateral osteoarthritis of hip: Case report

Abstract

Osteoarthritis of the hip is a common clinical problem and major causes of pain, disability and cost to the community through joint replacement surgery. Most studies examining structural changes in hip osteoarthritis have focussed on radiographic assessment but, a major limitation is that radiographs do not capture the early structural changes that may occur before joint symptoms are recognised. By the time early radiographic joint space narrowing of the hip is detected, 13% of femoral head cartilage volume has already been lost. Depending on the age, degree of bony deformation, acetabular involvement, hip dislocation and soft tissue alteration numerous treatment strategies are available. Pre-operative planning based on a thorough clinical and radiographic examination is essential. The aim of planning is to determine the appropriate surgical technique (including the necessary access), to assess the quality and quantity of existing bone substance and finally, to select the appropriate implant and its best possible positioning. We present a case of 26 year old female patient with bilateral osteoarthritis secondary to coxa vara for whom, over the course of two years, modular bipolar hemiarthroplasty was done on the right hip and total hip arthroplasty was done on the left hip.