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Failure of Primary Total Hip Arthroplasty Secondary to New Onset of Paget Disease by Spencer Amundsen, Karl Koenig, Douglas Goodwin, and Vincent Memoli.

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Presentation on theme: "Failure of Primary Total Hip Arthroplasty Secondary to New Onset of Paget Disease by Spencer Amundsen, Karl Koenig, Douglas Goodwin, and Vincent Memoli."— Presentation transcript:

1 Failure of Primary Total Hip Arthroplasty Secondary to New Onset of Paget Disease by Spencer Amundsen, Karl Koenig, Douglas Goodwin, and Vincent Memoli JBJS Case Connect Volume 5(1):e19 March 11, 2015 ©2015 by The Journal of Bone and Joint Surgery, Inc.

2 Preoperative anteroposterior (left) and cross-table (right) radiographs of the left hip demonstrating osteonecrosis of the femoral head with segmental collapse and secondary osteoarthritis. Spencer Amundsen et al. JBJS Case Connect 2015;5:e19 ©2015 by The Journal of Bone and Joint Surgery, Inc.

3 Anteroposterior (left) and cross-table (right) radiographs of the left hip six months after total hip arthroplasty showing cementless components without evidence of subsidence. Spencer Amundsen et al. JBJS Case Connect 2015;5:e19 ©2015 by The Journal of Bone and Joint Surgery, Inc.

4 Anteroposterior (left) and cross-table (right) radiographs of the left hip two years after primary arthroplasty demonstrating substantial femoral stem subsidence, cortical thickening, periostitis, and expansion of the greater trochanteric region. Spencer Amundsen et al. JBJS Case Connect 2015;5:e19 ©2015 by The Journal of Bone and Joint Surgery, Inc.

5 Anteroposterior (left) and lateral (right) radiographs of the right tibia showing an expanded mixed lytic and sclerotic lesion of the anterior tibial cortex extending from the proximal articular surface to the midshaft. Spencer Amundsen et al. JBJS Case Connect 2015;5:e19 ©2015 by The Journal of Bone and Joint Surgery, Inc.

6 Bone scan two years after the primary arthroplasty showing focal areas of increased activity in the proximal half of the left femur and the right tibia. Spencer Amundsen et al. JBJS Case Connect 2015;5:e19 ©2015 by The Journal of Bone and Joint Surgery, Inc.

7 Postrevision anteroposterior (left) and cross-table (right) radiographs of the left hip and the femur showing a long revision stem with a lateral cable-plate construct (bypassing an anterior cortical perforation). Spencer Amundsen et al. JBJS Case Connect 2015;5:e19 ©2015 by The Journal of Bone and Joint Surgery, Inc.

8 Anteroposterior (left) and cross-table (right) radiographs of the left hip and the femur showing no change in hardware position at the two-year follow-up. Spencer Amundsen et al. JBJS Case Connect 2015;5:e19 ©2015 by The Journal of Bone and Joint Surgery, Inc.


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