02009nas a2200229 4500000000100000008004100001260001200042653002800054653003200082653002200114653002600136100001400162700001200176700001300188700001400201245005500215856007600270300001000346490000700356520140200363022001401765 2020 d c01/202010aCharcot’s arthropathy10aHip Arthroplasty in leprosy10aLeprosy arthritis10aarticular involvement1 aAgrawal R1 aSingh V1 aSharma A1 aMangale N00aLeprosy-Induced Hip Arthritis: A Rare Case Report. uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8051578/pdf/JOCR-10-71.pdf a71-750 v103 a
Introduction: Leprosy is a chronic granulomatous infection, classically presents with cutaneous and neurological manifestations. Joint involvement in leprosy can present as acute symmetrical or chronic polyarthritis with or without tenosynovitis resembling rheumatoidarthritis.
Case Report: We report a rare case of lepromatous hip arthritis in a 32-year-old male, known case of leprosytenosynovitis and symmetrical polyarthritis of hands and feet 3 weeks after appearance of typical cutaneous lesion. The patient was started on anti-leprosy and steroid treatment. After 9 months of treatment and recurrent exacerbation of symptoms, the patient developed bilateral hip pain. Hip pain was diagnosed as bilateral avascular necrosis hip on magnetic resonance imaging which progressed to the left hip arthritis later on. The patient underwent staged total hip arthroplasty (THA) for the left hip arthritis, with debridement and antibiotic spacer in the first stage and final hip prosthesis in the second stage.
Conclusions: Leprosy can present with large joint-like hip involvement including tenosynovitis and acutesymmetrical polyarthritis. Two-stage THA is an alternative treatment option for patients with advanced arthritis of the hip under some difficult conditions. The Harris hip score was increased from 35 preoperatively to 91.5 at the final follow-up.
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