TOTAL HIP JOINT REPLACEMENT IN YOUNG MALE PATIENT WITH OSTEOPOROSIS, SECONDARY TO HYPOGONADOTROPIC HYPOGONADISM

Introduction. Hypogonadotropic hypogonadism is n endocrine disease with a major effect on bone tissue turnover eading to bone demineralization and secondary osteoporosis. Case report. A 42 year old man underwent a total ft hip joint arthroplasty for a left aseptic femoral head ecrosis with an unsatisfactory evolution because of pain, larked functional deficit, limping and instability sensation the operated lower limb. Five years before the patient was iagnosed with hypogonadotropic hypogonadism presenting ynecomastia, gynoid fat distribution, eunuchoidal skeletal roportions, reduced facial hair, a Tanner III stage of the xternal genital development, without erectile dysfunction. 'he unsatisfactory post-operative result was secondary to n aseptic mechanical degradation due to bone mineral loss secondary osteoporosis) and also application of undersized on-cemented implant. Standard biological analyses did not how modification, the inflammatory tests were negative. The XA examination, after a period of 2 years without treatment, howed a decrease of bone mineral density and confirms the iagnosis of secondary osteopenia. It was made the decision f surgical intervention and replacement of the uncemented emoral component with a cemented one. After the surgery, he therapy with bisphosphonates, calcium, vitamin D3 and estosterone is reinitiated. Discussion. The clinical outcome of biointegration f a non-cemented prosthesis depends in first of all of the iological status of the patient, with normal BMD, normal alcium and D vitamin levels. The secondary osteoporosis with Dcal aseptic inflammation on the surface of the prosthesis and one contact led to mechanical failure which maked necessary he revision surgery, in order to replace the prosthesis with a emented one. Conclusions. In our case the presence of typogonadotropic hypogonadism with secondary osteoporosis, epresents a contraindication for non-cemented total hip joint rthroplasty, due to major risk of loosening.