[Translated article] Primary total hip arthroplasty in patients with sequelae of poliomyelitis

• Published in: Revista española de cirugía ortopédica y traumatología 2023-09, Vol.67 (5), p.T401-T410
• Main Authors: Rodríguez-Zamorano, P., Otero Otero, J., Pérez González, A., Moro Rodríguez, L.E., Marco, F.
• Format: Article
• Language: English
• Subjects: Artroplastia total de cadera; Coxarthrosis; Coxartrosis; Dislocation; Displasia; Dysplasia; Luxación; Miembro parético; Paretic limb; Poliomielitis; Poliomyelitis; Total hip arthroplasty
• ISSN: 1888-4415; 1988-8856
• DOI: 10.1016/j.recot.2023.06.007

Total hip arthroplasty (THA) in patients with residual poliomyelitis (RP) is a surgical challenge. Dysplastic morphology, osteoporosis and gluteal weakness hinder orientation, increase fracture risk and reduce implant stability. The aim of this study is to describe a series of patients with RP treated by THA. Retrospective descriptive study of patients with RP treated with THA between 1999 and 2021 in a tertiary hospital, with clinical and radiological follow-up and functional and complication evaluation until present or death, with a minimum of 12 months. Sixteen patients underwent surgery, with 13 THA implanted in the paretic limb, 6 for fracture and 7 for osteoarthritis, while the remaining 3 were implanted in the contralateral limb. Four dual mobility cups were implanted as an antiluxation measure. At 1 year postoperatively, 11 had complete range of motion with no increase in Trendelenburg cases. The Harris hip score (HHS) improved 32.1 points, the visual analogue scale (VAS) 5.25 points, and the Merlé-d’Augbiné-Poste scale 6 points. The length discrepancy correction was 13.77mm. Median follow-up was 3.5 years (1–24). Two cases were revised for polyethylene wear and two for instability, with no infections, periprosthetic fractures, or cup or stem loosening. THA in patients with RP allows improvement of the clinico-functional situation with an acceptable complication rate. The risk of dislocation could be minimised with dual mobility cups. La prótesis total de cadera (PTC) en pacientes con secuelas de poliomielitis (SP) supone un reto quirúrgico. La morfología displásica, la osteoporosis y la debilidad glútea dificultan la orientación, incrementan el riesgo de fractura y reducen la estabilidad del implante. El objetivo de este estudio es describir una serie de pacientes con SP tratados mediante PTC. Estudio descriptivo retrospectivo de pacientes con SP intervenidos mediante PTC entre 1999 y 2021 en un hospital de tercer nivel, con seguimiento clínico y radiológico, y evaluación funcional y de las complicaciones hasta el presente o hasta el fallecimiento, con un mínimo de 12 meses. Se intervinieron 16 pacientes, implantándose 13 PTC en el miembro parético, 6 por fractura y 7 por coxartrosis, mientras que las otras 3 PTC se implantaron en el miembro contralateral. Se implantaron 4 cotilos de doble movilidad como medida antiluxante. Al año postoperatorio, 11 presentaban un balance articular completo sin aumentar los casos de Trendelenburg. El Harris Hip Sc