Severe osteolysis in a patient with Legg-Calvé-Perthes disease 32 years after primary total hip replacement : A case report

Abstract

This article presents a case report of a 73-year-old woman with Legg-Calvé-Perthes disease (LCPD) which developed late-onset osteolysis after a primary total hip replacement (THR). LCPD is a complex childhood hip disorder that can cause bone necrosis, deformation, and premature osteoarthritis with an increased risk of osteolysis after primary THR and therefore a higher risk of revision surgery. The acetabular component was unstable, with pronounced polyethene wear, and mechanical deformation and loosening of the acetabular component. The case was managed with the revision of THR using a non-cemented acetabular and femoral component, polyethene insert and ceramic head, which resulted in a smooth postoperative period. The article also discusses the incidence of LCPD and its association with osteolysis, highlighting the importance of considering medical history to manage complications after primary THR.