Smith-Petersen Vitallium Mold Arthroplasty: Case Report with a Fifty-One-Year Follow-Up and Histopathologic Analysis.

Abstract

Before the advent of total hip arthroplasty, cup arthroplasty was the main method used for hip reconstruction. In 1923, M.N. Smith-Petersen devised the first mold arthroplasty of the hip, made from glass, at the Massachusetts General Hospital; in 1939, he revised the implant to a cup made from Vitallium, a cobalt-chrome alloy1. Vitallium mold arthroplasty became the standard procedure for hip arthroplasty until the introduction of a low-frictional torque arthroplasty by Sir John Charnley in the 1960s2. We present a patient with a fifty-one-year follow-up of a Smith-Petersen mold arthroplasty with histological analysis of the femoral head. To the best of our knowledge, there has never been a longer follow-up of this type of arthroplasty published in the North American literature. The patient was informed that data concerning the case would be submitted for publication, and she provided consent. The patient, a sixty-three-year-old otherwise healthy woman, had undergone a Smith-Petersen mold arthroplasty of the left hip in 1961 at the age of twelve following pinning of a slipped capital femoral epiphysis that had failed secondary to osteonecrosis of the femoral head. She had functioned remarkably well with this procedure and was able to maintain a normal lifestyle for five decades. In the several years prior to presentation, however, she had developed progressively worsening left hip and lower back pain with increasingly limited left hip range of motion, and she had begun to use a cane with increasing frequency while walking. Physical examination while walking revealed a mild limp with no Trendelenburg gait. The …