A Challenging Case of Post Septic Sequelae of Hip in a Young Adult Female Treated with Total Hip Replacement and Limb Lengthening

A 20-year-old girl presented to us with a history of septic arthritis of the right hip in childhood, with complaints of painful limp and shortening. Examination revealed restricted hip ROM and an ipsilateral hypoplastic limb. Radiographs revealed a high overriding trochanter with destruction of the head and neck of the femur. CT scan revealed a dysplastic acetabulum, giving a dysplastic hip picture. After thorough pre-operative evaluation and ruling out of quiescent infection, we performed total hip replacement with Subtrochanteric osteotomy followed by a limb lengthening procedure. Union at the osteotomy site was achieved at four months follow-up. The shortening was managed with a limb lengthening procedure using a limb reconstruction system on the tibia. On subsequent follow-up, the patient did well with a painless stable hip and elimination of limp.