Orthopedic Challenges in Avascular Necrosis Management: A Case Report of Surgical Complications and Multidisciplinary Care

• Published in: Curēus (Palo Alto, CA) Vol. 16; no. 4; p. e57629
• Main Authors: Ansari, Ali Z, Patel, Dhruv U, Desai, Shivum, Manawa, Adarsh, Patibandla, Srihita, Kratz, Kurt
• Format: Journal Article
• Language: English
• Published: United States Cureus Inc 04.04.2024; Cureus
• Subjects: Anesthesia; Blood pressure; Bone surgery; Case reports; Emergency medical care; Emergency Medicine; Fractures; Hemoglobin; Hypotension; Joint surgery; Necrosis; Orthopedics; Pain; Patients; Prostheses; Radiology; Surgical outcomes; X-rays; postoperative management; total hip arthroplasty: tha; post-operative pain management; joint contracture; hip avascular necrosis; orthopedic intervention; hip surgery; orthopedic implant-related infection; prolonged hospitalization; surgical intervention
• ISSN: 2168-8184; 2168-8184
• DOI: 10.7759/cureus.57629

A 52-year-old woman, with a multifaceted medical background encompassing spinal cord injury, pneumonia, and recurrent hospitalizations, presents with enduring left hip and leg discomfort ultimately diagnosed as avascular necrosis (AVN). She previously underwent intraosseous direct anterior arthroplasty (DAA) of the left hip during the removal of orthopedic artifacts. Despite enduring hypertension, severe trochanter dislocation, and prosthesis fracture, she recovered and required additional surgery to address the dislocation and fracture. This case underscores the challenges in diagnosing and treating AVN, emphasizing the importance of meticulous postoperative care and a multidisciplinary approach. Challenges highlighted by AVN include delayed diagnosis, intricate surgical procedures, and the potential need for further interventions due to hardware complications and infection as seen in this patient.