Cases reported "Osteoarthritis, Hip"

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1/40. A new case of NSAID-induced infertility.

    A 38-year-old woman on piroxicam for hip osteoarthritis secondary to hip dysplasia developed secondary sterility. Ova collected for in vitro fertilization were immature and failed to fertilize. A further attempt done after piroxicam discontinuation produced seven mature ova that fertilized, allowing embryo implantation. Nonsteroidal antiinflammatory drugs may induce infertility by reducing the production of prostaglandins, most notably via inhibition of the enzyme cyclooxygenase 2. The impact of nonsteroidal antiinflammatory drug therapy on reproductive function needs to be evaluated.
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ranking = 1
keywords = osteoarthritis, arthritis
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2/40. Total hip arthroplasty after failed intertrochanteric valgus osteotomy for advanced osteoarthrosis.

    Thirty hips that had undergone conversion total hip arthroplasty because of failed intertrochanteric valgus osteotomy for advanced osteoarthrosis were analyzed clinically and radiographically for more than 2 years. The average followup after total hip arthroplasty was 7 years (range, 2-18 years). The average age of the patients at the time of valgus osteotomy was 42 years (range, 30-63 years). The average age of the patients at the time of conversion total hip arthroplasty was 57 years (range, 43-76 years), and the average period between valgus osteotomy and conversion was 14 years (range, 3-24 years). Perioperative complications in conversion total hip arthroplasties were minimal, and intramedullary reaming was performed easily. Of the 30 conversion total hip arthroplasties, 12 cemented and 18 cementless components were used, respectively. Kaplan-Meier's survival analysis indicated that survivorship of cemented stems was significantly higher than that of conventional cementless stems. Cemented stems are preferable for conversion total hip arthroplasty after failed femoral valgus osteotomy.
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ranking = 41.299492033128
keywords = osteoarthrosis
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3/40. Pathophysiology of surgical site infection in total hip arthroplasty.

    This article is a case report of a 69-year-old man who underwent a right total hip replacement procedure and developed a surgical site infection. Areas of concern in prevention and treatment of hip arthroplasty infection are presented, focusing on the pathophysiologic process involved. A review of the patient risk factors and the pathophysiologic action potentiating risk for infection include host immunity, nutritional status, diabetes, age, use of steroids or immunosuppressive drugs, rheumatoid arthritis, and urinary tract or other infections. The case report identifies the patient's age, multiple instrumentation of the bladder resulting in bacteriuria and the reinfusion of 400 cc of autologous shed blood via cell saver, a controversial risk subject, as the primary risk factors for surgical site infection in this patient. Readmission to the hospital on day 16 after the operation was completed on identification of 2 pathogenic organisms, methicillin-resistant staphylococcus aureus and acinetobacter calcoaceticus bio anitratus. The infection was successfully treated with oral ciprofloxacin and intravenous administration of tobramycin, preventing progression from superficial to deep infection and preserving the prosthesis.
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ranking = 5.7682097079608E-5
keywords = arthritis
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4/40. Failure after customized curved femoral stems in total hip arthroplasty for Paget's disease.

    We describe 2 patients with Paget's disease who underwent total hip arthroplasty for osteoarthrosis. In view of the femoral deformity in each case, a custom-made, long, curved femoral stem was used. Both patients have subsequently sustained periprosthetic fractures at the level of the tip of the prosthesis.
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ranking = 8.2598984066256
keywords = osteoarthrosis
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5/40. osteolysis in a cementless, second generation metal-on-metal hip replacement.

    A 65-year-old man with osteoarthritis of the hip underwent a cementless total hip replacement with a modern generation, metal-on-metal bearing. Two years later the patient presented with localized osteolysis at the tip of the femoral stem. At the time of revision, the stem was found to be well-fixed. Extensive analyses of the bearing surfaces and periprosthetic tissues were done. There was minimal bearing surface wear and only small numbers of inflammatory cells, such as macrophages, in the tissues, and it was concluded that this was not a typical case of particle-induced osteolysis. All cultures and laboratory studies were negative for infection. This case report supports the multifactorial nature of osteolysis, which includes the osteolytic potential of joint fluid access to and fluid pressures within, the effective joint space.
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ranking = 1
keywords = osteoarthritis, arthritis
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6/40. Can ischemic hip disease cause rapidly destructive hip osteoarthritis? A case report.

    Avascular osteonecrosis of the femoral head (AONFH) usually goes through the four stages described by Arlet and Ficat: normal radiographs, heterogeneity and sclerosis of the femoral head, subchondral fracture with an individualized sequestrum, and secondary osteoarthritis. Arlet and Ficat individualized a specific pattern of AONFH which they called ischemic hip disease, in which cartilage damage seen as concentric joint space loss precedes the bony alterations. Although radiological and pathological studies of ischemic hip disease have been published, no clinical data are available. We report the case of a 65-year-old man admitted for a 1-month history of severe hip symptoms with concentric joint space loss but no osteophytes. Laboratory tests and examination of fluid aspirated from the hip ruled out septic arthritis and inflammatory hip disease. Two magnetic resonance imaging (MRI) studies done 1 month apart showed diffuse edema involving not only the femoral head but also the neck and trochanter, as well as major synovial hypertrophy. This atypical MRI appearance prompted synovial membrane and pertrochanteric core biopsies, which showed reactive synovitis and stage IV osteonecrosis, respectively. The pain, disability, and joint space loss worsened. Total hip arthroplasty was performed 1 month after the biopsy. Histological examination of the femoral head showed diffuse necrosis; no evidence of another condition was found on histological sections of the entire synovial membrane. This case corroborates the hypotheses put forward by Lequesne that some cases of rapidly destructive hip osteoarthritis may be ascribable to ischemia.
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ranking = 6.0000576820971
keywords = osteoarthritis, arthritis
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7/40. Apparent spontaneous joint restoration in hip osteoarthritis.

    Dramatic spontaneous restoration of the joint space in osteoarthritis of the hip is rare, although limited fibrocartilaginous repair is common. regeneration of the apparent radiographic joint space seems to be associated with peripheral osteophyte formation, but it is difficult to isolate other well-defined factors that promote it. Previous documentation of the phenomenon exists in scattered case reports before the era of widespread total hip replacement. Two recent cases are presented in which patients with bilateral disease had unilateral total hip replacement with simultaneous diminished pain in the contralateral hip accompanied by restoration of the radiographic joint space. Secondary stability, unloading, peripheral osteophyte formation, and other possible factors likely contribute to these unusual natural outcomes of coxarthrosis.
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ranking = 5
keywords = osteoarthritis, arthritis
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8/40. Non-Hodgkin's lymphoma as an unexpected diagnosis in a hip arthroplasty.

    Total hip replacement is routinely performed for osteoarthritis of the hip joint. We report a case of Non-Hodgkin's lymphoma as an unexpected diagnosis after routine pathological examination of the bone block harvested during total hip replacement in an asymptomatic patient. Although controversies exist regarding the cost effectiveness of routine specimen evaluation during total hip replacement, we suggest that histological analysis of any unusual-looking surgical tissues is appropriate and should be performed in all the patients who have suspicious surgical findings. To our knowledge, this is the first case of lymphoma detected during primary total hip replacement.
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ranking = 1
keywords = osteoarthritis, arthritis
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9/40. A report of two cases treated with Pauwels' femoral osteotomy for advanced osteoarthritis resulting from a sequela of infectious coxitis in childhood.

    Pauwels' femoral valgus osteotomy was performed on two osteoarthritic hips that developed as a sequela of infectious coxitis in the childhood. One of the hips was diagnosed as osteomyelitis of the ipsilateral femur before the operation and was treated with curettage and implantation of antibiotic-impregnated cement beads. The results of both hips were excellent and maintained for 9-11 years.
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ranking = 4
keywords = osteoarthritis, arthritis
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10/40. Postpartum periarticular hip abscess with later coxitis caused by group B streptococcus.

    Intrapartum haematogenous spread of vaginal group B streptococcus is rare, but it can lead to severe complications like abscesses, endocarditis and meningitis postpartum. We report a postpartum periarticular hip abscess caused by group B streptococcus. Clinically it caused pain in the hip and a compression of the femoral nerve with motor and sensory component. diagnosis was made by aspiration under computed tomography control. The only sign of infection was an increased sedimentation rate. After antibiotic treatment the symptoms disappeared and the abscess vanished, but it was reactivated 4 months after delivery, leading to arthritis of the hip joint. Another antibiotic treatment was administered for 8 weeks. 17 months postpartum the patient is well, but a development of a secondary coxarthrosis can not be excluded.
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ranking = 5.7682097079608E-5
keywords = arthritis
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