Endoprosthesis in paraplegics with periarticular ossification of the hip

doi:doi:10.1038/sj.sc.3101387

Spinal Cord (2003) 41, 29–33. doi:10.1038/sj.sc.3101387

Endoprosthesis in paraplegics with periarticular ossification of the hip

S W J Becker¹, K Röhl¹ and F Weidt¹

¹Centre for Spinal Injuries, BG Trauma Centre, Halle Saale, Germany

Correspondence: S W J Becker, Centre for Spinal Injuries, Berufsgenossenschaftliche Kliniken Bergmannstrost Merseburger Str. 165, D-06112 Halle/Saale, Germany

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Abstract

Study design: Clinical study.

Objectives: To evaluate indications of hip endoprosthesis in periarticular ossifications.

Setting: A Spinal Cord Injury Centre in Germany.

Methods: Clinical examination, X-ray control.

Results: Surgery of periarticular ossification (paraosteoarthropathy, POA) either involves simple resection of the ossification or removal of the hip. The latter has an impact on the sitting posture with concomitant increased pressure sore risk. Nevertheless the hip is biomechanically important in paraplegics. We are investigating the outcome of total hip replacement (THR) in patients with ankylosis due to periarticular ossification. Six hip replacement cases seen in follow-up of up to 24 months showed no loosening, with good mobility of the joint. We follow a strict perioperative POA prophylaxis, which resulted in each case reporting only a slight recurrence (Brooker 1–2) without any loss of functional mobility.

Conclusion: In ankylotic hips with mobility/social/hygenic problems we favour a hip replacement in cases with osteoarthritis or high risk of osteoporotic fracture. A replacement of the joint should be preferred to a Girdlestone operation.