Hip and pelvic pain during pregnancy or after delivery is a common problem in young females, and in most cases this problem has a self-limiting course. The patient described in this case suffered from severe hip pain after childbirth. MR imaging study was performed and it showed arthritis of bilateral hip joints and osteomyelitis of femoral heads with an abscess in the surrounding muscle. Infection, such as septic arthritis or osteomyelitis, is an extremely rare cause of peripartum joint pain. The patient's clinical symptoms and laboratory findings improved with antibiotic therapy. However, limitation of motion of the bilateral hip joints persisted although the patient continued rehabilitative therapy for 15 months, and the patient had to undergo bilateral total hip replacement. Hereby, we present a case of severe osteomyelitis and pyogenic arthritis of bilateral femoral heads and hip joints after delivery, which eventually required bilateral total hip replacement.

Citations

Citations to this article as recorded by  

• Burkholderia cepacia Vertebral Osteomyelitis Following Cesarean Section: Case Report and Review of the Literature
  Suha Kalash , Zeina A. Kanafani
  Microbes, Infection and Chemotherapy.2023; 3: e1859.     CrossRef
• Bilateral Erosive Septic Hip Arthritis Following Pregnancy
  Emily A. Treu, Christopher E. Pelt, Michael J. Archibeck
  Arthroplasty Today.2022; 16: 192.     CrossRef
• Incremental Value of Three-Phase Bone Scintigraphy and Single-Photon Emission Computed Tomography–Computed Tomography in a Case of Postpartum PUO in the Wake of The Antibiotic-Resistance Era
  Pramukh Kulkarni, Indirani M. Elangoven, A Jaykanth, Shelley Simon
  Indian Journal of Nuclear Medicine.2021; 36(1): 62.     CrossRef

Objective: To determine the functional outcomes of the patients with total hip replacement and to evaluate the variables associated with the functional recovery.

Method: Subjects were 188 patients, who had undertaken total hip replacement between March 1, 1997 and July 31, 1999 at Asan Medial Center. The four functional milestones including sitting, standing, 50 m walking, and climbing stairs were evaluated.

Results: The average duration of treatment was 8.3⁑7.0 days, and the days required for sitting were 1.9⁑1.0; standing 2.4⁑1.8; walking 50 m 6.4⁑4.3; climbing stairs 7.9⁑4.5 days. In results of analysis of each variable, male patients showed faster functional improvement than female patients in standing and climbing stairs. The patients of age 60 years and over had slower recovery in sitting and standing. The patients with sequelae of septic hip or Legg-Calve-Perthes disease had slower recovery than the others in standing. The patient with the use of cement showed rapid improvement in sitting and standing. Those who could bear full weight had rapid recovery than those with partial weight.

Conclusion: We would like to suggest that careful consideration on characteristics of each patient should be given in determining the duration of rehabilitation management of the patients who had total hip replacement.