Journal of Nippon Medical School: Vol.67 No.4 page.267

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ArticleTitle A Case Report of Insufficiency Fracture of the Fossa Acetabuli in a Patient with Rheumatoid Arthritis

AuthorList Daiya Ozaki, Yasumasa Shirai, Yoshihito Nakayama and Shinji Uesaka

Affiliation Department of Orthopedic Surgery, Nippon Medical School

Language EN

Volume 67

Issue 4

Year 2000

Page 267-270

Received January 18, 2000

Accepted March 8, 2000

Keywords insufficiency fracture, rheumatoid arthritis, acetabulum

Abstract Aside from vertebral compression fractures, the most common site of insufficiency fractures is the pelvis and lower extremities. In the pelvis, the fractures usually occur in the ilium, the pubis and the ischium, but rarely in the fossa acetabuli. We report a severe insufficiency fracture of the fossa acetabuli in a 78-year-old woman with rheumatoid arthritis (RA). She had associated insufficiency fractures of the rib, the thoracic spine and the sacrum. In our case, senile osteoporosis was present before the onset of the fracture was recognized on radiographs, and RA and corticosteroid therapy might have further aggravated the porosis, resulting in the destruction of the fossa acetabuli. Regarding treatment for the fracture, a cemented total hip replacement without bone graft was attempted for several reasons such as the patient's activities, postoperative rehabilitaion and the bone mass of the acetabulum. The postoperative course was satisfactory during study period. However, further follow-up is needed to monitor carefully how the patient will be in the future.

Correspondence to Daiya Ozaki, MD, Department of Orthopedic Surgery, Nippon Medical School 2nd Hospital, 1-396 Kosugi-cho, Nakahara-ku, Kawasaki-shi, Kanagawa 211-8533, Japan
daiya@nms.ac.jp

ArticleTitle	A Case Report of Insufficiency Fracture of the Fossa Acetabuli in a Patient with Rheumatoid Arthritis
AuthorList	Daiya Ozaki, Yasumasa Shirai, Yoshihito Nakayama and Shinji Uesaka
Affiliation	Department of Orthopedic Surgery, Nippon Medical School
Language	EN
Volume	67
Issue	4
Year	2000
Page	267-270
Received	January 18, 2000
Accepted	March 8, 2000
Keywords	insufficiency fracture, rheumatoid arthritis, acetabulum
Abstract	Aside from vertebral compression fractures, the most common site of insufficiency fractures is the pelvis and lower extremities. In the pelvis, the fractures usually occur in the ilium, the pubis and the ischium, but rarely in the fossa acetabuli. We report a severe insufficiency fracture of the fossa acetabuli in a 78-year-old woman with rheumatoid arthritis (RA). She had associated insufficiency fractures of the rib, the thoracic spine and the sacrum. In our case, senile osteoporosis was present before the onset of the fracture was recognized on radiographs, and RA and corticosteroid therapy might have further aggravated the porosis, resulting in the destruction of the fossa acetabuli. Regarding treatment for the fracture, a cemented total hip replacement without bone graft was attempted for several reasons such as the patient's activities, postoperative rehabilitaion and the bone mass of the acetabulum. The postoperative course was satisfactory during study period. However, further follow-up is needed to monitor carefully how the patient will be in the future.
Correspondence to	Daiya Ozaki, MD, Department of Orthopedic Surgery, Nippon Medical School 2nd Hospital, 1-396 Kosugi-cho, Nakahara-ku, Kawasaki-shi, Kanagawa 211-8533, Japan daiya@nms.ac.jp