The Longest Known Follow‐Up of Vitallium Mold Arthroplasty in China: A Case Report and Literature Review

• Published in: Orthopaedic surgery Vol. 15; no. 7; pp. 1915 - 1919
• Main Authors: Leng, Junsheng, Peng, Huiming, Feng, Bin, Weng, Xisheng
• Format: Journal Article
• Language: English
• Published: Melbourne John Wiley & Sons Australia, Ltd 01-07-2023; John Wiley & Sons, Inc; Wiley
• Subjects: Arthroplasty; Arthroplasty, Replacement, Hip; Cartilage; Case Report; Case Reports; China; Ethics; Follow-Up Studies; Follow‐up; Fungi; Hip - surgery; Hip joint; Hospitals; Humans; Infections; Joint replacement surgery; Kidney cancer; Leukocytes; Male; Middle Aged; Necrosis; Neutrophils; Pain; Pathology; Patients; Revision surgery; Total hip arthroplasty; Tuberculosis; Vitallium; Vitallium mold arthroplasty; X-rays; China; Vitallium mold arthroplasty; Revision surgery; Total hip arthroplasty; Follow-up
• ISSN: 1757-7853; 1757-7861
• DOI: 10.1111/os.13765

Background
Before the advent of total hip arthroplasty, Vitallium mold arthroplasty had been widely performed. We present a case with a 42‐year follow‐up after Vitallium mold arthroplasty. To our knowledge, this case represents the longest known follow‐up of Vitallium mold arthroplasty in China.
Case presentation
This was a 59‐year‐old male. He underwent Vitallium mold arthroplasty of the left hip 42 years ago because of osteonecrosis of the femoral head. He developed left hip pain 3 months ago and underwent total hip revision surgery. There was some clear synovial fluid in the hip joint. The mold was loosened entirely and taken out effortlessly. Gram‐positive cocci could be observed occasionally in the synovial fluid smear, while the synovial fluid culture was negative. The inflammatory markers elevated perioperatively, and prophylactic cefuroxime and vancomycin were utilized successively. All elevated inflammatory markers fell since postoperative day 5, and there was no other sign of infection. The pain and function of the hip joint improved significantly after surgery.
Conclusions
Although Vitallium mold arthroplasty was inferior to total hip arthroplasty in survival rate and functional outcome, it did provide an excellent long‐term function of the hip joint.
The patient underwent Vitallium mold arthroplasty of the left hip 42 years ago because of osteonecrosis of the femoral head. He developed left hip pain 3 months ago and underwent total hip revision surgery. The mold was loosened entirely and taken out effortlessly.