{"id":17871,"date":"2018-11-20T11:01:50","date_gmt":"2018-11-20T16:01:50","guid":{"rendered":"https:\/\/newyorkhipknee.com\/non-classifiee\/etude-de-cas-lr-remplacement-de-la-hanche-de-revision\/"},"modified":"2018-11-20T11:01:50","modified_gmt":"2018-11-20T16:01:50","slug":"etude-de-cas-lr-remplacement-de-la-hanche-de-revision","status":"publish","type":"post","link":"https:\/\/www.newyorkhipknee.com\/fr\/etude-de-cas\/etude-de-cas-lr-remplacement-de-la-hanche-de-revision\/","title":{"rendered":"\u00c9tude de cas : LR – Remplacement de la hanche de r\u00e9vision"},"content":{"rendered":"

M. LR est un homme de 53 ans qui a malheureusement d\u00e9velopp\u00e9 un changement arthritique \u00e0 la hanche droite \u00e0 un \u00e2ge relativement jeune. Il a \u00e9t\u00e9 vu par un chirurgien orthop\u00e9dique dans un autre \u00e9tablissement environ 10 ans avant qu\u2019il ne soit vu par moi-m\u00eame, et on lui a dit qu\u2019un resurfa\u00e7age de la hanche<\/a> serait la meilleure option chirurgicale pour lui. Il a ensuite subi cette proc\u00e9dure ainsi qu\u2019une ost\u00e9otomie redirectionnelle et a eu une p\u00e9riode d\u2019environ 5 \u00e0 6 ans sans douleur \u00e0 la hanche apr\u00e8s son r\u00e9tablissement.<\/p>\n

Au cours des 2-3 ann\u00e9es pr\u00e9c\u00e9dant sa visite \u00e0 notre clinique, il avait ressenti une augmentation de la raideur et de la douleur \u00e0 la hanche droite au point o\u00f9 sa d\u00e9marche \u00e9tait consid\u00e9rablement affect\u00e9e \u2013 en fait, c\u2019est ce facteur qui l\u2019a incit\u00e9 \u00e0 consulter un m\u00e9decin suppl\u00e9mentaire pour sa hanche. Malgr\u00e9 cela, il est rest\u00e9 aussi actif que possible, ne prenant des m\u00e9dicaments que pour la tension art\u00e9rielle et l\u2019hypercholest\u00e9rol\u00e9mie et n\u2019ayant aucune allergie m\u00e9dicamenteuse connue. Il ne fume pas non plus.<\/p>\n

L\u2019examen physique n\u2019a r\u00e9v\u00e9l\u00e9 essentiellement aucune amplitude de mouvement passive ou active dans sa hanche droite, son examen de la hanche gauche n\u2019\u00e9tait pas remarquable, tout comme l\u2019examen de ses genoux.<\/p>\n

Les radiographies \u00e0 film ordinaire ont r\u00e9v\u00e9l\u00e9 la raison de sa douleur et de son manque d\u2019amplitude de mouvement \u2013 il avait d\u00e9velopp\u00e9 une ossification h\u00e9t\u00e9rotopique \u00e9tendue autour de sa hanche resurfac\u00e9e au point o\u00f9 son corps avait essentiellement fusionn\u00e9 sa propre hanche \u2013 \u00e9galement connue sous le nom d\u2019ankylose.<\/p>\n

Nous avons discut\u00e9 de l\u2019\u00e9tat de M. LR avec lui et lui avons indiqu\u00e9 que s\u2019il souhaitait poursuivre la chirurgie, nous proc\u00e9derions \u00e0 un \u00ab retrait \u00bb de sa fusion et r\u00e9viserons son resurfa\u00e7age \u00e0 une arthroplastie totale de la hanche.<\/p>\n

Il a accept\u00e9, et \u00e0 ce titre, nous avons pratiqu\u00e9 une chirurgie de r\u00e9vision sur sa hanche droite. Nous avons utilis\u00e9 la m\u00eame approche que le chirurgien pr\u00e9c\u00e9dent \u2013 dans ce cas, une approche lat\u00e9rale. Nous avons rencontr\u00e9 des quantit\u00e9s importantes d\u2019os h\u00e9t\u00e9rotopique au cours de notre dissection que nous avons soigneusement et m\u00e9ticuleusement enlev\u00e9es. Nous avons finalement trouv\u00e9 le composant de resurfa\u00e7age f\u00e9moral dans la grande zone d\u2019ossification et l\u2019avons enlev\u00e9, ainsi que suffisamment d\u2019os pour permettre la restauration d\u2019une amplitude de mouvement confortable.<\/p>\n

Nous avons ensuite identifi\u00e9 le composant ac\u00e9tabulaire enti\u00e8rement en poly\u00e9thyl\u00e8ne enfoui profond\u00e9ment dans le champ chirurgical. Nous l\u2019avons retir\u00e9 en \u00e9caillant soigneusement le ciment qui le maintenait en place avant d\u2019enlever d\u00e9finitivement tous les restes de ciment une fois le composant extrait.<\/p>\n

Nous avons ensuite pr\u00e9par\u00e9 le f\u00e9mur et l\u2019ac\u00e9tabulum pour nos composants de r\u00e9vision, et les avons plac\u00e9s en position sans \u00e9v\u00e9nement. Nous avons termin\u00e9 la proc\u00e9dure avec une hanche stable avec une bonne amplitude de mouvement.<\/p>\n

3 mois apr\u00e8s l\u2019op\u00e9ration, M. LR avait retrouv\u00e9 la majeure partie de ses forces dans sa hanche et se d\u00e9place sans douleur et est de retour au travail.<\/p>\n","protected":false},"excerpt":{"rendered":"

M. LR est un homme de 53 ans qui a malheureusement d\u00e9velopp\u00e9 un changement arthritique \u00e0 la hanche droite \u00e0 un \u00e2ge relativement jeune. Il a \u00e9t\u00e9 vu par un chirurgien orthop\u00e9dique dans un autre \u00e9tablissement environ 10 ans avant qu\u2019il ne soit vu par moi-m\u00eame, et on lui a dit qu\u2019un resurfa\u00e7age de la […]<\/p>\n","protected":false},"author":9,"featured_media":17436,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_et_pb_use_builder":"","_et_pb_old_content":"","_et_gb_content_width":"","footnotes":""},"categories":[1159],"tags":[],"class_list":["post-17871","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-etude-de-cas"],"yoast_head":"\nLR - Remplacement de la hanche de r\u00e9vision | Meilleur chirurgien de la hanche et du genou<\/title>\n<meta name=\"description\" content=\"M. 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