THA Revision Pathway Posted: 4/3/2022 ID: (C102028) ICJR 9th Annual Revision Hip & Knee Course

Painful Total Hip Arthroplasty in 58M

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CASE DESCRIPTION

AGE	58 / Male
CC	L hip pain
HPI	A 58-year-old male presents with left hip pain that has been progressive over the last 6 months. He initially had a hemi resurfacing for AVN at the age of 16. This was subsequently converted to a THA in 1987. Two years later he underwent acetabular revision for aseptic loosening, which served him well for 10 years. In 1999, he underwent a 2-stage reconstruction for a gram negative infection and has been doing well up until the last 6 months. He denies any fevers, chills or incisional pain.
PMH	PMH: None PSH: as above Social Hx: nonsmoker, lives with wife
PE	General: BMI 20 Focused exam of the LLE demonstrates a 3 cm leg length discrepancy. Active range of motion is 80 degrees flexion, 10 degrees of IR/ER. There is pain with Stinchfield testing. Prior incision is well healed without evidence of erythema or drainage. He is neurovascularly intact distally. Labs: ESR 2, CRP <1

AGE/GENDER:

58 / Male

CHIEF COMPLAINT:

L hip pain

HISTORY OF PRESENT ILLNESS:

A 58-year-old male presents with left hip pain that has been progressive over the last 6 months. He initially had a hemi resurfacing for AVN at the age of 16. This was subsequently converted to a THA in 1987. Two years later he underwent acetabular revision for aseptic loosening, which served him well for 10 years. In 1999, he underwent a 2-stage reconstruction for a gram negative infection and has been doing well up until the last 6 months. He denies any fevers, chills or incisional pain.

PAST MEDICAL HISTORY:	PMH: None PSH: as above Social Hx: nonsmoker, lives with wife
PHYSICAL EXAM:	General: BMI 20 Focused exam of the LLE demonstrates a 3 cm leg length discrepancy. Active range of motion is 80 degrees flexion, 10 degrees of IR/ER. There is pain with Stinchfield testing. Prior incision is well healed without evidence of erythema or drainage. He is neurovascularly intact distally. Labs: ESR 2, CRP <1
DIAGNOSIS:	Painful Total Hip Arthroplasty in 58M