Total Hip Arthroplasty After Contralateral Hip Disarticulation: A Challenging 'Simple Primary'

摘要

Patients with lower limb amputation have a high incidence of hip and knee osteoarthritis in both the residual limb and the contralateral limb. Hip disarticulation is a radical surgery usually performed in younger patients after malignancy or trauma. Compliance is poor with existing prostheses, resulting in increased dependency on and use of the remaining sound limb.We describe a case of a crutch-walking 51-year-old woman who presented with severe left hip arthritis 25 years after a right hip disarticulation, and was treated with total hip arthroplasty. Total hip arthroplasty without a contralateral hip joint is challenging. We discuss the complex technical considerations associated with the patient's arthroplasty, in particular the selection of prostheses and bearing surfaces, and the preoperative and intraoperative assessment of limb length and offset.