Total Hip Arthroplasty and Perioperative Management of a Patient with Hip Osteonecrosis Secondary to Hypopituitarism Due to Sheehan Syndrome: A Case Report and Literature Review

Clicks: 4
ID: 310154
Article Quality & Performance Metrics
Overall Quality
Not rated
Combines reader engagement with the AI quality analysis. This article has not been analysed, so there is no overall score — reader engagement is measured and shown alongside.
AI Quality Assessment
Not analyzed
Readership in this journal
Emerging

Ranked #58 of 490 articles by views in Frontiers in surgery

Most read Least read

Bar heights use a square-root scale. Only the 120 most-read articles are drawn; the journal has 490 in total.

Mint this article as an NFT
Not yet minted

Create a permanent, verifiable on-chain record of this article on the Scimatic Network. The NFT is held in your Journament account, and you can withdraw it to your own wallet at any time.

5 SUSD one-off · no wallet required
Abstract
Background: Sheehan's syndrome, a rare disorder resulting from postpartum hemorrhage-induced necrosis of the anterior pituitary gland, necessitates long-term hormone replacement therapy with glucocorticoids. This predisposes patients to severe complications, including rapid-progression osteonecrosis of the femoral head (ONFH), which carries a high disability rate. Methods: We report a 63-year-old female with Sheehan's syndrome diagnosed 30 years ago, managed with sustained prednisone and levothyroxine. She presented with 10 years of bilateral hip pain and imaging-confirmed bilateral ONFH at ARCO stage IV. A multidisciplinary team (MDT) approach was implemented: endocrinology optimized preoperative hormone regimens, orthopedics planned total hip arthroplasty (THA) based on bone density assessments, and anesthesiology confirmed tolerability for intraspinal anesthesia. After stabilizing physiological parameters, left THA was performed. Results: Intraoperative hydrocortisone infusion maintained hormonal homeostasis. The surgery proceeded uneventfully; however, an allergic reaction occurred during blood transfusion, which was promptly controlled. Postoperative MDT-coordinated care enabled ambulation with a walker within one week, with unrestricted left hip mobility and no complications (e.g., infection, prosthesis loosening). Conclusion: THA for glucocorticoid-induced ONFH in Sheehan's syndrome entails challenges such as perioperative hormonal instability, elevated infection risk, and impaired bone healing. The MDT approach ensures comprehensive risk mitigation, facilitating surgical success and patient safety. Long-term follow-up for hormone levels, bone density, and prosthesis status is warranted.
Reference Key
imported_1768922236_696f9c7ca1956 Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors Chen, DeSheng
Journal Frontiers in surgery
Year Year not found
DOI
10.3389/fsurg.2026.1715057
URL
Keywords Keywords not found

Citations

No citations found. To add a citation, contact the admin at info@scimatic.org

No comments yet. Be the first to comment on this article.