case report patient total hip replacement failure due to radiation damaged pelvis

by Elyse Murray 8 min read

Patient With Total Hip Replacement, Case Study Example

32 hours ago The patient should keep a log of pain on a scale of 1 to 10, so that there should be a decrease in the level of pain as reported by the patient on a regular, daily basis. 2. Get out of bed and sit in a chair two or three times a day for 30 minutes, including walking a very short distance to the chair. This will begin to increase strength and ... >> Go To The Portal


What is the true incidence of hip replacement surgery?

The true incidence ranges from 0.3 – 3% and is dependent upon surgical, patient and implant factors (6). 6. Metal on Metal with Ions When a metal-on-metal artificial hip cup and ball grind together, tiny shavings can be released into the blood-stream and body causing pain and restriction.

What are the risks of revision hip replacements?

Compared with the initial hip replacement, revision hip replacements are associated with increased risk of complications including infection and dislocation (7). The longevity of the implant also decreases with each revision, due to increased wear on the bone site.

How was the patient positioned for a hip replacement?

The patient was brought to the operating room and anesthesia was obtained by the anesthesiologist. The patient was definitively positioned with the left hip up and the left hip was then draped and prepped in the usual sterile manner.

What are the reasons for hip replacement failure?

8 Reasons for Hip Replacement Failure. 1 1. Infection. Infection is a serious complication. The incidence in urban non-teaching hospital is 1.18% (2) 2 2. Loose Prosthesis. 3 3. Tendonitis. 4 4. Failure Due to Wear and Tear. 5 5. Dislocation. More items

Can radiation cause hip problems?

Radiotherapy for cancer in the pelvic area can sometimes lead to hip and pelvic bone problems later in life. Radiotherapy can damage bones in different ways. Problems after pelvic radiotherapy may include weaker bones and tiny cracks in the bones.

Can radiation cause AVN?

Avascular necrosis (AVN) constitutes a severe and challenging long-term complication in radiation oncology.

What causes the failure of total hip replacement?

Patient-related factors leading to the failure of total hip arthroplasty include co-morbidities such as sickle cell anaemia [14], poor bone quality [15], or other variables that may predispose the patient to infections or dislocation. Surgical technique may also affect the outcome of total hip arthroplasty.

Can pelvic radiation cause hip pain?

Pelvic radiotherapy can affect the bones in your pelvis, lower back and hips. It may cause tiny cracks in these bones. These are sometimes called pelvic insufficiency fractures. They don't always cause symptoms, but in some cases will cause pain or changes to mobility.

What are the 4 stages of avascular necrosis?

Stage 1 has a normal x-rays but MRI reveals the dead bone. Stage 2 can be seen on regular x-ray but there is no collapse of the femoral ball. Stage 3 shows signs of collapse (called a crescent sign) on x-ray. Stage 4 has collapse on x-ray and signs of cartilage damage (osteoarthritis).

Can osteonecrosis be cured?

Treatment can slow the progress of avascular necrosis, but there is no cure. Most people who have avascular necrosis eventually have surgery, including joint replacement. People who have avascular necrosis can also develop severe osteoarthritis.

How do you know if a hip replacement has failed?

Typical symptoms that you may have failed total hip replacement are pain in the hip, groin, or thigh as well as limited mobility. Some people describe feeling that the hip joint might “give out.”

Which is the most important factor for the success of total hip arthroplasty?

It is certain that the most important functional prognostic factor of primary total hip arthroplasty is the local condition immediately after surgery. An unsatisfactory condition would be followed by immediate poor results.

What is the most common cause of revision THA?

The most common reasons for revision were acetabular loosening (30.1%), femoral loosening (23.7%), and polyethylene wear (24.7%). 8.3% of patients underwent primary THA with highly cross-linked polyethylene, while the remainder of the patients underwent THA when conventional polyethylene was used.

Can pelvic radiation damage bones?

Pelvic radiotherapy can damage the bones in the pelvis, hips and lower back. This can weaken them and may cause tiny cracks.

What are the long term side effects of pelvic radiation?

Long term effects on the pelvis Radiotherapy to the pelvic area might cause: changes to your bowel habit. bladder inflammation causing pain in your tummy (abdomen) and feeling like you need to pass urine more often (let your doctor know if this happens as it could be an infection) fine cracks in the pelvic bones.

What side effects will most likely to occur to patient during radiation therapy to the pelvis?

Radiation therapy aimed at the pelvis may cause these side effects:Loose stool or diarrhea.Rectal bleeding.Incontinence, which is when a person is not able to control his or her bladder.Bladder irritation.Sexual problems for men, such as erectile dysfunction, which is the inability to get or maintain an erection.More items...

What is hip replacement?

Hip replacement, also called total hip arthroplasty is surgery to replace a worn-out or damaged hip joint with an artificial joint called a prosthesis. Once the injured joint is surgically removed the prosthesis is cemented into the thigh bone and pelvis. Prosthesis composites include metal, ceramic and hard plastic.

What is dislocation in prosthetics?

A dislocation is an injury where the ball portion of the prosthesis is forced out of the socket. The result is pain and limited function. The true incidence ranges from 0.3 – 3% and is dependent upon surgical, patient and implant factors (6).

Why does my hip hurt after hip replacement?

There are many causes of hip pain after replacement. The most common include infection, loose prosthesis, tendonitis, hip replacement failure, dislocation, metal ions, prosthesis fracture, and the wrong diagnosis. Other causes of hip pain include spinal disorders, nerve disorders, and sacroiliac joint dysfunction. If your hip replacement surgery has been canceled due to COVID-19 please take this time to better understand your hip pain, its sources and possible treatment options that are not complicated by infection, toxic metal ions, fracture, dislocation, and limited longevity requiring additional surgery. PRP and bone marrow concentrate injections are effective, non-surgical treatment options for your ongoing hip pain. Don’t be sidelined by your hip pain. Call us to better understand your options.

What causes a prosthesis to loosen?

The main mechanism for loosening is thought to be wear particles from the prosthesis itself which in turn triggers an inflammatory reaction. Wear particles are microscopic fragments from the prosthesis. Over time the inflammatory response eats away the bone surrounding the prosthesis causing loosening (4).

What is the pain of a hip prosthesis?

Pain is the prominent symptom and prompt evaluation is important since a loose prosthesis can rub on the hip socket potentially causing additional bone loss and making future surgical repairs more difficult. 3. Tendonitis. Tendons are the thick bands of connective tissue that connect muscle to bones.

Why do prosthesis fractures hurt?

The most common causes for prosthesis fracture include increasing patient longevity and increased levels of activity. Fractures are associated with poor clinical outcomes and high mortality rate (7). 8. The Wrong Diagnosis.

What causes hip pain?

Spinal Disorder Disc injuries, disc herniations, disc slippage and narrowing of the canal (stenosis) can all cause hip pain. Nerve Disorders – Nerve irritation or compression can be a source of hip pain and should always be evaluated.