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Total Hip Arthroplasty in Patients With Postpolio Residual Paralysis: A Systematic Review

Published:January 22, 2021DOI:https://doi.org/10.1016/j.arth.2021.01.046

      Abstract

      Background

      Patients with postpolio residual paralysis can develop disabling hip arthritis in paralytic as well as a nonparalytic limb, warranting total hip arthroplasty (THA). Limited literature is available on the results of THA among these patients in the form of small series or case reports. We have undertaken a systematic review to evaluate the clinical outcome of THA in patients with poliomyelitis with hip pathologies.

      Methods

      A systematic search of electronic databases of PubMed, Scopus, and Web of Science pertaining to English literature was undertaken from 1945 to August 2020 to assess the results of THA in patients with poliomyelitis. Information was gathered about demographics, indication, clinical course, complications, functional outcome, survival, and need for any revision surgery in these patients.

      Results

      The literature search revealed 81 articles. Finally, after deduplication and manual selection, 16 relevant articles (128 hips) were included for evaluation. There is a paucity of literature evaluating THA in patients with poliomyelitis over the last 2 decades. The principal reason for arthroplasty was osteoarthritis of the hip in the ipsilateral (paralyzed) limb. A combination of cemented, uncemented, and hybrid implant fixation system was found to be used by surgeons. Addressing instability and perioperative management of limb length discrepancy were found to be challenging propositions.

      Conclusion

      THA remains an effective intervention to relieve pain and improve quality of life in patients of poliomyelitis afflicted with either primary or secondary arthritis of the hip. The use of uncemented nonconstrained hip implant designs appears to demonstrate better results than constrained implants.

      Keywords

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      References

        • Howard R.S.
        Poliomyelitis and the post-polio syndrome.
        BMJ. 2005; 330: 1314-1318
        • Bennett J.E.
        • Dolin R.
        • Blaser M.J.
        Mandell, Douglas, and Bennett’s Principles and Practice of Infectious Diseases.
        8th ed. Saunders, Philadelphia, PA2014
        • Gupta M.
        • Jain V.K.
        • Upadhyaya G.K.
        • Arya R.K.
        Comprehensive review of challenges associated with management of lower limb fractures in poliomyelitis patients.
        J Clinorthop Trauma. 2016; 7: 276-281https://doi.org/10.1016/j.jcot.2016.08.007
        • Lau J.H.
        • Parker J.C.
        • Hsu L.C.
        • Leong J.C.
        Paralytic hip instability in poliomyelitis.
        J Bone Joint Surg Br. 1986; 68: 528-533
        • Meek R.M.D.
        • Allan D.B.
        • McPhillips G.
        • Kerr L.
        • Howie C.R.
        Epidemiology of dislocation after total hip arthroplasty.
        Clinorthoprelat Res. 2006; 447: 9-18
        • Yoon B.H.
        • Lee Y.K.
        • Yoo J.J.
        • Kim H.J.
        • Koo K.H.
        Total hip arthroplasty performed in patients with residual poliomyelitis: does it work?.
        Clinorthoprelat Res. 2014; 472: 933-940
        • Laguna R.
        • Barrientos J.
        Total hip arthroplasty in paralytic dislocation from poliomyelitis.
        Orthopedics. 2008; 31: 179https://doi.org/10.3928/01477447-20080201-16
        • Spinnickie A.
        • Goodman S.B.
        Dissociation of the femoral head and trunnion after constrained conversion total hip arthroplasty for poliomyelitis.
        J Arthroplasty. 2007; 22: 634-637https://doi.org/10.1016/j.arth.2006.05.011
        • Kraay M.J.
        • Bigach S.D.
        The neuromuscularly challenged patient: total hip Arthroplasty is now an option.
        Bone Joint J. 2014; 96-B: 27-31https://doi.org/10.1302/0301-620X.96B11.34346
        • Li J.
        • Zheng W.
        • Zhao J.
        • Liu D.
        • Xu W.
        Large diameter metal on metal total hip arthroplasty for femoral neck fractures with neurological conditions: a retrospective assessment.
        Indian J Orthop. 2014; 48: 605-611https://doi.org/10.4103/0019-5413.144236
        • Cabanela M.E.
        • Weber M.
        Total hip arthroplasty in patients with neuromuscular disease.
        Instr Course Lect. 2000; 49: 163-168
        • Liu H.
        • Gu W.
        • Sun J.
        Medium-term effectiveness of total hip arthroplasty with straight tapered rectangular femoral prosthesis.
        Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2013; 27: 594
        • Sobrón F.B.
        • Martínez-Ayora Á.
        • Cuervas-Mons M.
        • Quevedo T.
        • Laguna R.
        • Vaquero J.
        Total hip arthroplasty in patients of post-polio residual paralysis: a retrospective case series.
        Indian J Orthop. 2017; 51: 434-439https://doi.org/10.4103/0019-5413.209951
        • Sakamoto M.
        • Watanabe H.
        • Kubosawa H.
        • Ishii T.
        Unusual MRI findings in a polio survivor.
        Case Rep Orthop. 2016; : 3179621https://doi.org/10.1155/2016/317962
        • Sonohata M.
        • Kitajima M.
        • Kawano S.
        • Mawatari M.
        Total hip arthroplasty for the paralytic and non-paralytic side in patient with residual poliomyelitis.
        Open Orthop J. 2016; : 10105-10110https://doi.org/10.2174/1874325001610010105
        • Sonekatsu M.
        • Sonohata M.
        • Kitajima M.
        • Kawano S.
        • Mawatari M.
        Total hip arthroplasty for patients with residual poliomyelitis at a mean eight years of follow-up.
        Acta Med Okayama. 2018; 72: 17-22https://doi.org/10.18926/AMO/55658
        • Buttaro M.A.
        • Slullitel P.A.
        • GarcíaMansilla A.M.
        Long-term outcome of unconstrained primary total hip arthroplasty in ipsilateral residual poliomyelitis.
        Orthopedics. 2017; 40: e255-e261https://doi.org/10.3928/01477447-20161108-03
        • Cameron H.U.
        Total hip replacement in a limb severely affected by paralytic poliomyelitis.
        Can J Surg. 1995; 38: 386
        • Cho Y.J.
        • Lee C.H.
        • Chun Y.S.
        • Rhyu K.H.
        Outcome after cementless total hip arthroplasty for arthritis hip in patients with residual poliomyelitis: a case series.
        Hip Int. 2016; 26: 458-461https://doi.org/10.5301/hipint.5000372
        • DeDeugd C.M.
        • Perry K.I.
        • Trousdale W.H.
        • Taunton M.J.
        • Lewallen D.G.
        • Abdel M.P.
        Total hip arthroplasty in patients affected by poliomyelitis.
        Bone Joint J. 2018; 100-B: 733-739https://doi.org/10.1302/0301-620X.100B6.BJJ-2018-0127.R1
        • Faldini C.
        • De Fine M.
        • Di Martino A.
        • Fabbri D.
        • Borghi R.
        • Chehrassan M.
        • et al.
        Outcomes of total hip replacement in limbs affected by poliomyelitis.
        Hip Int. 2017; 27: 198-204https://doi.org/10.5301/hipint.5000451
        • Glyn J.H.
        • Sutherland I.
        • Walker G.F.
        • Young A.C.
        Low incidence of osteoarthrosis in hip and knee after anterior poliomyelitis: a late review.
        BMJ. 1966; 2: 739-742
        • Jameson S.S.
        • Lees D.
        • James P.
        Lower rates of dislocation with increased femoral head size after primary total hip arthroplasty: a five-year analysis of NHS patients in England.
        J Bone Joint Surg Br. 2011; 93-B: 876-880
        • Hernigou P.
        • Filippini P.
        • Flouzat-Lachaniette C.H.
        • Batista S.U.
        • Poignard A.
        Constrained liner in neurologic or cognitively impaired patients undergoing primary THA.
        Clinorthoprelat Res. 2010; 468: 3255-3262
        • Duncan C.P.
        Fusion takedown: can be a let-down.
        Orthopedics. 2007; 30: 758-759https://doi.org/10.3928/01477447-20070901-10
        • El-Husseiny M.
        • Masri B.
        • Duncan C.
        • Garbuz D.S.
        Long-term results of tripolar constrained total hip arthroplasty in revision hip arthroplasty: a minimum follow-up of ten years.
        Bone Joint J. 2019; 101-B: 123-126https://doi.org/10.1302/0301-620X.101B6.BJJ-2018-1484.R1
        • Giori N.J.
        • Lewallen D.G.
        Total knee Arthroplasty in limbs affected by poliomyelitis.
        J Bone Joint Surg Am. 2002; 84: 1157-1161