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Total Hip Arthroplasty Performed in Patients with Residual Poliomyelitis: Does it Work?

  • Clinical Research
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Clinical Orthopaedics and Related Research®

A CORR Insights to this article was published on 19 November 2013

Abstract

Background

Patients with residual poliomyelitis can have advanced degenerative arthritis of the hip in the paralytic limb or the nonparalytic contralateral limb. Although THA is a treatment option for some of these patients, there are few studies regarding THA in this patient population.

Questions/purposes

We therefore reviewed a group of patients with residual poliomyelitis who underwent cementless THA on either their paralytic limb or nonparalytic limb to assess (1) Harris hip scores, (2) radiographic results, including implant loosening, (3) complications, including dislocation, and (4) limb length discrepancy after recovery from surgery.

Methods

From January 2000 to December 2009, 10 patients with residual poliomyelitis (10 hips, four paralytic limbs and six nonparalytic contralateral limbs) underwent THA using cementless prostheses. Harris hip scores, complications, and leg length discrepancy were determined by chart review, and confirmed by questionnaire and examination; radiographs were reviewed by two observers for this study. Followup was available for all 10 patients at a minimum of 3 years (median, 7 years; range, 3.4–13 years). Surgery was done at the same side of the paralytic limb in four hips and contralateral to the paralytic limb in six.

Results

All patients had pain relief and improvement in function; the Harris hip score improved from mean of 68 preoperatively to 92 at last followup (p = 0.043). However, only three patients had complete pain relief. One hip dislocated, which was treated successfully with closed reduction and a hip spica cast for 2 months. There was no loosening or osteolysis in this series. Leg length discrepancy improved after the index operation, but only in the THAs performed in the paralytic limbs.

Conclusions

Cementless THA may be suitable for painful hips in adult patients with residual poliomyelitis. Nonetheless, these patients should be informed of the possibility of mild residual pain and persistent leg length discrepancy, particularly patients whose THA is performed on the limb that was not affected by polio (ie, the nonparalytic contralateral limb).

Level of Evidence

Level IV, therapeutic study. See the Instructions for Authors for a complete description of levels of evidence.

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Acknowledgments

We gratefully acknowledge Young Min Kim MD, our teacher, who also contributed several patients to this study.

Author information

Authors and Affiliations

  1. Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Seongnam, South Korea

    Byung-Ho Yoon MD, Young-Kyun Lee MD & Kyung-Hoi Koo MD

  2. Department of Orthopaedic Surgery, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 110-744, South Korea

    Jeong Joon Yoo MD, PhD & Hee Joong Kim MD

Authors
  1. Byung-Ho Yoon MD
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  2. Young-Kyun Lee MD
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  3. Jeong Joon Yoo MD, PhD
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  4. Hee Joong Kim MD
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  5. Kyung-Hoi Koo MD
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Corresponding author

Correspondence to Jeong Joon Yoo MD, PhD.

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Each author certifies that he or she, or a member of his or her immediate family, has no funding or commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.

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Clinical Orthopaedics and Related Research neither advocates nor endorses the use of any treatment, drug, or device. Readers are encouraged to always seek additional information, including FDA-approval status, of any drug or device prior to clinical use.

Each author certifies that his or her institution approved the human protocol for this investigation, that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participation in the study was obtained.

This work was performed at the Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul, Korea.

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Yoon, BH., Lee, YK., Yoo, J.J. et al. Total Hip Arthroplasty Performed in Patients with Residual Poliomyelitis: Does it Work?. Clin Orthop Relat Res 472, 933–940 (2014). https://doi.org/10.1007/s11999-013-3338-3

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  • DOI: https://doi.org/10.1007/s11999-013-3338-3

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