Title:Arthritis of the Hip Caused by Arteriovenous Malformations: A Case Report
Volume: 20
Author(s): Xiao Yu, Xiao-Qiang Zhou, Jie Lin, Jing-Yu Zhang, Suo-Yuan Li, Yu-Bo Liu, Da-Yong Zhou, Jing-Huan Lv, Guang-Xiang Chen and Ren-Jie Xu*
Affiliation:
- Department of Orthopedics, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing
Medical University, Suzhou 215000, Jiangsu Province, China
Keywords:
Hip pain, Arthritis, Arteriovenous malformations, Multi-modality blood conservation strategy, Total hip replacement, Case report.
Abstract:
Background:
Arthritis of the hip caused by arteriovenous malformations (AVMs) has been rarely reported. Therefore, total hip replacement (THR) in patients
with AVM-induced arthritis of the hip is challenging.
Case Summary:
We report a 44-year-old woman with aggravated right hip pain during the past decade. The patient presented with severe pain and a functional
disorder of the right hip. X-ray examination revealed severely narrowed right hip joint space and abnormal trabecular bone loss in the femoral neck
and trochanter area. Doppler ultrasound, magnetic resonance imaging and computed tomography angiography revealed AVMs surrounding the
right hip, along with erosion. To ensure the safety of THR, we performed vascular embolization and temporary balloon occlusion of the iliac artery
three times during the operation. However, serious hemorrhage occurred, which was rescued by the multimodality blood conservation strategy.
THR was successfully performed, and the patient was discharged 8 d later for rehabilitation. Postoperative pathological examination showed
osteonecrosis of the femoral head with malformed thick-walled vessels and focal granulomatous inflammation of the surrounding soft tissues. The
Harris Hip Scale score increased from 31 to 82 at 3 mo of follow-up. The patient was followed up for 1 year, and all her clinical symptoms were
significantly alleviated.
Conclusion:
Arthritis of the hip caused by AVMs is rare in clinical practice. The activity and function of the involved hip joint can be effectively treated with
THR after comprehensive imaging and multidisciplinary consultation.
Core Tip:
Arthritis of the hip caused by arteriovenous malformations is rarely reported. Total hip replacement (THR) is a reliable and effective option for the
treatment of advanced arthritis of the hip. We report a 44-year-old woman with aggravated pain in the right hip during the past decade. With the
vascular intervention and multimodality blood conservation strategy. THR can be successfully performed in patients with AVM-induced arthritis
of the hip.
