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Search for Cause of Hip Arthrokatadysis

In this paper, two cases of hip arthrokatadysis first reported in 1929 are reprinted. Arthrokatadysis is a sinking-in of the hip socket (acetabulum). The patient with this condition presents with hip pain and loss of motion.

The underlying cause of this problem remains unknown. In the first case, a 37-year-old homemaker developed symptoms after the birth of her first child. There was a history of phlebitis (blood clots) linked with her pregnancy.

She reported burning pain in the hip joint area and a gradual loss of motion. Muscle wasting was observed at the time of the medical exam. The affected leg was one-fourth of an inch shorter than the uninvolved side. X-rays did show subsidence (sinking) of the acetabulum into the pelvis. The hip was not dislocated.

Dr. Richard A. Brand, who reviewed these cases with today's knowledge and information, offered the following opinion. The arthrokatadysis may have occurred as a result of a disturbance in the vascular supply to the hip.

Since there was a history of blood clots, it's possible that the acetabulum did not get the nutrition it needed. Softening and sinking of the bone resulted.

In the second case, a 43-year-old woman had symptoms in both hips. X-rays showed hip dislocation on both side (worse on the left). Dr. Brand suggested the bilateral presentation points to a systemic cause. Lab tests were negative, but there may have been a glandular problem of some type.

This condition and these cases were presented with an invitation for other similar cases to be reported and studied. Finding the cause of the problem may help identify the best treatment approach. Previous management with rest, casting, manipulation, and physical therapy have not been proven effective.

References: N. Austin Cary, MD, FACS and Leonard Barnard, MD. The Classic: Arthrokatadysis of the Hip Joint. In Clinical Orthopedics and Related Research. December 2007. Vol. 465. Pp. 4-5.

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