Rapidly Progressive Osteoarthritis of the Hip Secondary to a Subchondral Insufficiency Fracture of the Acetabulum: A Case Report
Article Sidebar
Published:
Apr 14, 2021
Keywords:
Insufficiency fracture, acetabulum, total hip arthroplasty
Main Article Content
Abstract
Subchondral insufficiency fractures are a rare cause of hip pain. Unlike acute traumatic fractures, acetabulum insufficiency fractures are less common than femoral fractures. They commonly occur in postmenopausal women with comorbidities. Its initial diagnosis is usually difficult and clinical suspicion is of great importance. Magnetic resonance imaging (MRI) is a fundamental tool for the detection of this pathology. Underestimating these injuries can lead to the development of rapidly progressive osteoarthritis and joint replacement as an outcome. We present the case of a 68-year-old patient with a subchondral insufficiency fracture of the acetabulum who underwent uncemented total hip arthroplasty.
Downloads
Download data is not yet available.
Metrics
Metrics Loading ...
Article Details
How to Cite
Lucero, C. M., Díaz Dilernia, F., Zanotti, G., Comba, F., Piccaluga, F., & Buttaro, M. (2021). Rapidly Progressive Osteoarthritis of the Hip Secondary to a Subchondral Insufficiency Fracture of the Acetabulum: A Case Report. Revista De La Asociación Argentina De Ortopedia Y Traumatología, 86(2), 228-234. https://doi.org/10.15417/issn.1852-7434.2021.86.2.1090
Issue
Section
Case Presentations
Copyright (c) 2021 Revista de la Asociación Argentina de Ortopedia y Traumatología
Manuscript acceptance by the Journal implies the simultaneous non-submission to any other journal or publishing house. The RAAOT is under the Licencia Creative Commnos Atribución-NoComercial-Compartir Obras Derivadas Igual 4.0 Internacional (CC-BY-NC.SA 4.0) (http://creativecommons.org/licences/by-nc-sa/4.0/deed.es). Articles can be shared, copied, distributed, modified, altered, transformed into a derivative work, executed and publicly communicated, provided a) the authors and the original publication (Journal, Publisher and URL) are mentioned, b) they are not used for commercial purposes, c) the same terms of the license are maintained.
In the event that the manuscript is approved for its next publication, the authors retain the copyright and will assign to the journal the rights of publication, edition, reproduction, distribution, exhibition and communication at a national and international level in the different databases. data, repositories and portals.
It is hereby stated that the mentioned manuscript has not been published and that it is not being printed in any other national or foreign journal.
The authors hereby accept the necessary modifications, suggested by the reviewers, in order to adapt the manuscript to the style and publication rules of this Journal.
References
1. Kawano K, Motomura G, Ikemura S, Kubo Y, Hatanaka H, Utsunomiya T, et al. Subchondral insufficiency fracture of the femoral head in an elderly woman with symptomatic osteoarthritis of the contralateral hip. J Orthop Sci 2018;S0949-2658(18)30043-5. hppts://doi.org/10.1016/j.jos.2018.02.001
2. Kimura T, Goto T, Hamada D, Tsutsui T, Wada K, Fukuta S, et al. Subchondral insufficiency fracture of the femoral head caused by excessive lateralization of the acetabular rim. Case Rep Orthop 2016;2016:4371679.
https://doi.org/10.1155/2016/4371679
3. Hackney LA, Lee MH, Joseph GB, Vail TP, Link TM. Subchondral insufficiency fractures of the femoral head:
associated imaging findings and predictors of clinical progression. Eur Radiol 2016;26(6):1929-41. https://doi.org/10.1007/s00330-015-3967-x
4. Yamamoto T, Bullough PG. The role of subchondral insufficiency fracture in rapid destruction of the hip joint: a
preliminary report. Arthritis Rheum 2000;43(11):2423-7. https://doi.org/10.1002/1529-0131(200011)43:11<2423::AID-ANR8>3.0.CO;2-Z
5. Jauregui JJ, Clayton A, Kapadia BH, Cherian JJ, Issa K, Mont MA. Total hip arthroplasty for acute acetabular
fractures: a review of the literature. Expert Rev Med Devices 2015;12(3):287-95.
https://doi.org/10.1586/17434440.2015.1009828
6. Pentecost RL, Murray RA, Brindley HH. Fatigue, insufficiency, and pathologic fractures. JAMA 1964;28(187):1001-4. https://doi.org/10.1001/jama.1964.03060260029006
7. Sakamoto A, Yamamoto T, Tanaka K, Matsuda S, Yoshida T, Iwamoto Y. Insufficiency fracture in the paraacetabulum, with features mimicking those of a malignant bone tumor. Clin Med Case Rep 2008;1:73-6.
https://doi.org/10.4137/ccrep.s803
8. Brennan M, O’Shea PM, O’Keeffe ST, Mulkerrin EC. Spontaneous insufficiency fractures. J Nutr Health Aging
2019;23(8):758-60. https://doi.org/10.1007/s12603-019-1234-6
9. Wearing SC, Hennig EM, Byrne NM, Steele JR, Hills AP. Musculoskeletal disorders associated with obesity: a
biomechanical perspective. Obes Rev 2006;7(3):239-50. https://doi.org/10.1111/j.1467-789X.2006.00251.x
10. Schachter AK, Roberts CS, Seligson D. Occult bilateral acetabular fractures associated with high-energy trauma and osteoporosis. J Orthop Trauma 2003;17(5):386-9. https://doi.org/10.1097/00005131-200305000-00012
11. Watarai K, Taneda H, Higano M, Hirasawa Y, Oda H. Rapidly destructive arthrosis of the hip joint after insufficiency fracture of the acetabulum. J Orthop Sci 2008;13(6):561-5. https:/doi.org/10.1007/s00776-008-1261-3
12. Angles F, Coscujuela A, Tramunt C, Panisello MG, Portabella F. Complication of an insufficiency fracture of the
acetabulum. Hip Int 2008;18(3):236-8. https://doi.org/10.5301/hip.2008.2237
13. Ikemura S, Mawatari T, Matsui G, Iguchi T, Mitsuyasu H. Clinical outcomes in relation to locations of bone marrow edema lesions in patients with a subchondral insufficiency fracture of the hip: a review of fifteen cases. Br J Radiol 2016;89(1066):20150750. https://doi.org/10.1259/bjr.20150750
14. Buttaro M, Della Valle AG, Morandi A, Sabas M, Pietrani M, Piccaluga F. Insufficiency subchondral fracture of the femoral head: report of 4 cases and review of the literature. J Arthroplasty 2003;18(3):377-82.
https://doi.org/10.1054/arth.2003.50092
15. Cabarrus MC, Ambekar A, Lu Y, Link TM. MRI and CT of insufficiency fractures of the pelvis and the proximal
femur. AJR Am J Roentgenol 2008;191(4):995-1001. https://doi.org/10.2214/AJR.07.3714
16. Guerado E, Cano JR, Cruz E. Occult acetabular fracture in elderly patients. Open Orthop J 2012;6:582-6.
https://doi.org/10.2174/1874325001206010582
17. Jo WL, Lee WS, Chae DS, Yang IH, Lee KM, Koo KH. Decreased lumbar lordosis and deficient acetabular coverage are risk factors for subchondral insufficiency fracture. J Korean Med Sci 2016;31(10):1650-5.
https://doi.org/10.3346/jkms.2016.31.10.1650
18. Mears DC. Surgical treatment of acetabular fractures in elderly patients with osteoporotic bone. J Am Acad Orthop Surg 1999;7(2):128-41. https://doi.org/10.5435/00124635-199903000-00006
19. Bangil M, Soubrier M, Dubost JJ, Rami S, Carcanagues Y, Ristori JM, et al. Subchondral insufficiency fracture of
the femoral head. Rev Rheum Engl Ed 1996;63(11):85-61. PMID: 9010975
20. Lopez Viana S, Machado BB, Mendlovitz PS. MRI of subchondral fractures: a review. Skeletal Radiol 2014;43(11):1515-27. https://doi.org/10.1007/s00256-014-1946-y
2. Kimura T, Goto T, Hamada D, Tsutsui T, Wada K, Fukuta S, et al. Subchondral insufficiency fracture of the femoral head caused by excessive lateralization of the acetabular rim. Case Rep Orthop 2016;2016:4371679.
https://doi.org/10.1155/2016/4371679
3. Hackney LA, Lee MH, Joseph GB, Vail TP, Link TM. Subchondral insufficiency fractures of the femoral head:
associated imaging findings and predictors of clinical progression. Eur Radiol 2016;26(6):1929-41. https://doi.org/10.1007/s00330-015-3967-x
4. Yamamoto T, Bullough PG. The role of subchondral insufficiency fracture in rapid destruction of the hip joint: a
preliminary report. Arthritis Rheum 2000;43(11):2423-7. https://doi.org/10.1002/1529-0131(200011)43:11<2423::AID-ANR8>3.0.CO;2-Z
5. Jauregui JJ, Clayton A, Kapadia BH, Cherian JJ, Issa K, Mont MA. Total hip arthroplasty for acute acetabular
fractures: a review of the literature. Expert Rev Med Devices 2015;12(3):287-95.
https://doi.org/10.1586/17434440.2015.1009828
6. Pentecost RL, Murray RA, Brindley HH. Fatigue, insufficiency, and pathologic fractures. JAMA 1964;28(187):1001-4. https://doi.org/10.1001/jama.1964.03060260029006
7. Sakamoto A, Yamamoto T, Tanaka K, Matsuda S, Yoshida T, Iwamoto Y. Insufficiency fracture in the paraacetabulum, with features mimicking those of a malignant bone tumor. Clin Med Case Rep 2008;1:73-6.
https://doi.org/10.4137/ccrep.s803
8. Brennan M, O’Shea PM, O’Keeffe ST, Mulkerrin EC. Spontaneous insufficiency fractures. J Nutr Health Aging
2019;23(8):758-60. https://doi.org/10.1007/s12603-019-1234-6
9. Wearing SC, Hennig EM, Byrne NM, Steele JR, Hills AP. Musculoskeletal disorders associated with obesity: a
biomechanical perspective. Obes Rev 2006;7(3):239-50. https://doi.org/10.1111/j.1467-789X.2006.00251.x
10. Schachter AK, Roberts CS, Seligson D. Occult bilateral acetabular fractures associated with high-energy trauma and osteoporosis. J Orthop Trauma 2003;17(5):386-9. https://doi.org/10.1097/00005131-200305000-00012
11. Watarai K, Taneda H, Higano M, Hirasawa Y, Oda H. Rapidly destructive arthrosis of the hip joint after insufficiency fracture of the acetabulum. J Orthop Sci 2008;13(6):561-5. https:/doi.org/10.1007/s00776-008-1261-3
12. Angles F, Coscujuela A, Tramunt C, Panisello MG, Portabella F. Complication of an insufficiency fracture of the
acetabulum. Hip Int 2008;18(3):236-8. https://doi.org/10.5301/hip.2008.2237
13. Ikemura S, Mawatari T, Matsui G, Iguchi T, Mitsuyasu H. Clinical outcomes in relation to locations of bone marrow edema lesions in patients with a subchondral insufficiency fracture of the hip: a review of fifteen cases. Br J Radiol 2016;89(1066):20150750. https://doi.org/10.1259/bjr.20150750
14. Buttaro M, Della Valle AG, Morandi A, Sabas M, Pietrani M, Piccaluga F. Insufficiency subchondral fracture of the femoral head: report of 4 cases and review of the literature. J Arthroplasty 2003;18(3):377-82.
https://doi.org/10.1054/arth.2003.50092
15. Cabarrus MC, Ambekar A, Lu Y, Link TM. MRI and CT of insufficiency fractures of the pelvis and the proximal
femur. AJR Am J Roentgenol 2008;191(4):995-1001. https://doi.org/10.2214/AJR.07.3714
16. Guerado E, Cano JR, Cruz E. Occult acetabular fracture in elderly patients. Open Orthop J 2012;6:582-6.
https://doi.org/10.2174/1874325001206010582
17. Jo WL, Lee WS, Chae DS, Yang IH, Lee KM, Koo KH. Decreased lumbar lordosis and deficient acetabular coverage are risk factors for subchondral insufficiency fracture. J Korean Med Sci 2016;31(10):1650-5.
https://doi.org/10.3346/jkms.2016.31.10.1650
18. Mears DC. Surgical treatment of acetabular fractures in elderly patients with osteoporotic bone. J Am Acad Orthop Surg 1999;7(2):128-41. https://doi.org/10.5435/00124635-199903000-00006
19. Bangil M, Soubrier M, Dubost JJ, Rami S, Carcanagues Y, Ristori JM, et al. Subchondral insufficiency fracture of
the femoral head. Rev Rheum Engl Ed 1996;63(11):85-61. PMID: 9010975
20. Lopez Viana S, Machado BB, Mendlovitz PS. MRI of subchondral fractures: a review. Skeletal Radiol 2014;43(11):1515-27. https://doi.org/10.1007/s00256-014-1946-y