Department of Orthopaedic Surgery, Vayodha Hospital, Balkhu, Kathmandu, Nepal
Klippel-Trenaunay syndrome (KTS) is very rare and severe degenerative joint disease at an early age. Orthopedic intervention in these patients brings numerous difficulties for various reasons. Very few cases of total hip replacement in KTS have been documented in the literature. We present this case report, where a twenty-five-year male was presented with pain in left hip for the last eighteen months. Our contemporary method to conquer the situations dealt with this keen condition. Acetabular morphology was normal and also the bone quality was good enough, which permitted the use of a standard acetabular as well as femoral component. Non cemented acetabular and femoral component with large diameter articulation was selected. Pre-operative embolization was employed before forty-eight hours of surgery to minimize per operative blood loss from the intra-osseous vascular malformation; besides, a cell saver was also used pre-operatively, which helped to reduce allogeneic blood transfusion requirements. Significant bleeding was encountered per operatively from grossly abnormal vessels within the soft tissues, which was controllable with ligation and cautery. The patient was discharged on the fifth day of surgery; first follow-up was done at two weeks of surgery after complete healing of the wound. At sixteenth week follow-up, the patient was walking with a normal gait and was back to all desired activities.