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stability of joint in full extension and 90* flexion. In the coronal view, 93.3% in the CAS grouphad better outcomes compared with EM (73.4%). In the sagittal axis, 90.0% CAS also hadbetter outcomes compared with EM (63.3%). Computer-navigated total knee arthroplasty helpsincrease accuracy and reduce “outliers” for implant placement.Thursday, October 7, 2010, 14:50-15:30Session A6: Hip MiscellaneousMelorheostosis of the Hip Joint Treated With Total Hip Replacement*Ahsan Sheeraz - Royal National Orthopaedic Hospital, Stanmore - London, UKNatasha Picardo - Royal National Orthopaedic Hospital - Stanmore, United KingdomBhupinder Mann - RNOH, Stanmore, UK - London, UKJohn Skinner - Royal National Orthopaedic Hospital Trust - Stanmore, UKIntroduction:*Email: ahsanshiraz@hotmail.comMelorheostosis is a rare bone dysplasia characterized by its classic radiographic appearanceresembling dripping candle wax. The condition was originally described by Leri and Joanny in1922. Its etiology is not fully known and treatment in most instances has been symptomatic.There are nearly 350 reported cases on melorheostosis, joint replacement has been successfullyattempted in the shoulder and knee joint. We describe a case of severe melorheostosis affectingthe left hip causing secondary osteo-arthritis, which was treated with a total hip replacement(THR). To the best of our knowledge this is the first reported case of its kind in the Worldliterature.Case history:A 52-year-old male of Indian origin with known melorheostosis of the left leg for over 30years, presented with symptoms suggestive of severe osteo-arthritis of the left hip. Previouslyhe had been treated for melorheostosis of the knee joint (fig 1a & 1b) with excisions anddecompression of the medial femoral condyle. His left hip became more painful over the lastfew years. He had a fixed flexion deformity of 20° of the hip, severe muscle wasting and theaffected leg was 3 cm longer than the right leg. Radiographs (fig 2a & 2b) confirmed thepresence of sclerotic new bone in the acetabulum eroding the femoral head. He had the classicaldripping candle wax appearance along the medial border of the neck and shaft of the femur. Heunderwent a THR using a Corail-Pinnacle un-cemented prosthesis using ceramic onpolyethylene bearing surfaces (fig 3a & 3b). Post operatively he made a quick recovery andthere was a marked improvement in his symptoms and functional outcome scores at 6 weeks.Discussion:Melorheostosis has an incidence of 0.9 in one million and affects men and women equally. Itfile:///E|/ISTA2010-Abstracts.htm[12/7/2011 3:15:47 PM]