The Orthopaedic view of Transient Osteoporosis of the Hip in Pregnancy
Abstract
Scope. The analysis of Transient Osteoporosis of the Hip, which invades the 3rd trimester of pregnancy (TOHP) and arouses the interest of the Orthopedist in its treatment. It is a rare, unknown disease that presents with localized osteoporosis in the neck and femoral head, often bilateral and resolved spontaneously after 4-8 months. The reduction of the mechanical strength of the femoral neck carries the risk of fragility fracture. The diagnosis is made with the information from the history and the objective examination and is documented with Magnetic Resonance Imaging (MRI).
Material and Methods. During the last 25 years (1998-2023), out of a total of 85,000 deliveries, 18 cases of TOHP were diagnosed (0.021%). The symptoms of the onset of the disease were pain in the affected hip with lameness that limited daily activities.
Results. Treatment was conservative and included rest, discharge of the affected hip, analgesics and anti-osteoclastic drugs after childbirth. After 6-8 months, there was a complete remission of the manifestations of the disease, and only in one woman, the diagnosis was made after a fracture of fragility of the femoral neck that was treated surgically.
Conclusions. This rare disease (TOHP) has a benign progression and requires early diagnosis, with awareness of Obstetricians Gynecologists and Orthopedic Surgeons, for the immediate initiation of therapeutic measures. Protection from a possible femoral neck fragility fracture, as well as surgical repair if it occurs, are critical issues for the successful final outcome of pregnancy.
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References
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