Bone deformities after 10 years of hip osteoarthritis

Ho Chi Minh City Mr. Than, 32 years old, has had hip degeneration and inflammation for more than 10 years, currently has deformed skeleton, one leg is shorter than the other.

Mr. Than's right hip joint is completely stiff, he cannot lift his leg, his spine is curved... More than 10 years ago, he was diagnosed with degenerative arthritis of the hip joint, the doctor prescribed surgery but for many reasons he has not received treatment. Mr. Than cannot do strenuous activities, play sports, cannot carry heavy objects of about 5-10 kg, his daily life is affected.

On April 12, Master, Doctor, Doctor Dang Khoa Hoc, Head of the Department of General Orthopedics and Traumatology, Tam Anh General Hospital, Ho Chi Minh City, said that Mr. Than's condition was very complicated. Adhesive inflammation, stiffness and severe degeneration of the hip joint for a long time without proper treatment caused the spine to curve to one side, the pelvis to tilt upward, contraction of the iliopsoas and abductor muscles, asymmetry in muscle tone on both sides, and a difference in leg length of nearly 4 cm. The patient needs immediate hip replacement surgery to restore mobility.

According to Dr. Hoc, the patient's condition posed many challenges for the surgical team. The two main parts that make up the hip joint, the acetabulum and the femoral head, were completely damaged; the joint was stiff and unable to move. The risk of dislocation after surgery was very high due to the large difference in leg length, unequal muscle tone on both sides, and severe scoliosis.

Patients are indicated to replace the hip joint using the minimally invasive SuperPATH surgical technique instead of conventional surgical methods, limiting damage to already weakened muscle groups and contractures; ensuring rebalance of muscle strength in both legs; choosing the appropriate joint type to avoid dislocation...

Doctor Hoc (right) performs joint replacement surgery on a patient. Illustration photo: Tam Anh General Hospital — Doctor Hoc (right) performs joint replacement surgery on a patient. Illustration photo: *Tam Anh General Hospital*

On the first day after surgery, the patient no longer has pain, can walk comfortably and steadily, without needing any assistive devices.

However, the difference in length between his two legs was too great due to hip joint damage, pelvis and spine tilt. The leg length could not be immediately balanced after surgery. The patient needed to coordinate with long-term rehabilitation exercises to balance the strength of the bilateral abductor muscles, help reduce the pelvis tilt; restore the paraspinal muscle groups, correct the curvature of the spine and restore gait balance.

It is estimated that after 3-6 months, Mr. Than can restore 80-90% of his balanced gait, improving his low leg and high leg condition. After this time, he still needs to continue practicing to fully restore his natural gait.

Patient walking after surgery. Photo: Tam Anh General Hospital — Patient walking after surgery. Photo: *Tam Anh General Hospital*

Doctor Hoc advised patients not to replace joints too early because no joint is better than a natural joint. However, when a doctor has prescribed it, patients should have surgery early to avoid serious complications affecting the spine, pelvis, knee joints, ankle joints, etc.

SuperPath is an advanced hip replacement technique with many advantages such as short incision, no muscle cutting, short surgery time, less blood loss... Thanks to that, patients have less pain and recover faster. Usually, one day after surgery, patients can walk normally with a walker.

Phi Hong

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