SOMA Orthopedics
Medical Group Inc.
Case Overview:
D.P. is a 53 year old male who presented with
progressively worsening pain in his right groin.
His pain had been present for over 2 years prior to
consultation. D.P. is employed as a high school
physical education teacher who enjoys coaching the
varsity football team. In the past, he had been
able to control a majority of his pain with
non-steroidal anti-inflammatory medications and
activity modifications. In recent months, D.P.
noted the severity of the pain had increased to the
point that he is having difficulty standing and
walking for prolonged periods of time. Due to his
current level of pain and dysfunction, he was no
longer able to effectively perform duties as a
teacher or a coach. He no longer was able to
participate in many of his usual hobbies, including
gardening and bowling. Within the few weeks prior
to consultation, D.P.’s pain had progressed
to the point of making it difficult to sleep
comfortably.

Due to the patient’s progressive symptoms, clinical examination and radiographic examination, surgery was recommended. He subsequently underwent a total right hip arthroplasty. Because of his physiologic age, activity level and bone quality, a non-cemented femoral stem was used in conjunction with an oxynium femoral head articulating with a highly cross-linked polyethylene liner.
Outcome:
Since D.P.’s surgery, he has had a complete resolution of his arthritic pain. The patient has an antalgic gait and examination demonstrates a resolution of his Trendlenberg sign with symmetrical strength and ROM in his lower extremities. He no longer depends on anti-inflammatory medications and has been able to resume working and coaching full time without any discomfort. He has reconnected with his hobbies and has recently begun to loose weight with a guided exercise program. D.P. has recently characterized his total hip replacement as a “new lease on life.”
Clinical
Overview:
The patient was referred by his primary physician
to our physicians for further evaluation. Physical
examination demonstrated a Trendlenberg gait and
pain localized to the groin with full passive
flexion and internal rotation. He also indicated
some discomfort with a straight leg raise. AP and
lateral radiographs of his hip demonstrated end
stage osteoarthritis with extensive involvement of
both the femoral head and acetabulum.