, Volume 47, Issue 2, pp 301–305 | Cite as

Osseous hydatidosis of the proximal femur: a rare diagnosis in revision total hip arthroplasty

  • Frank S. FröschenEmail author
  • H. P. Fischer
  • G. T. Hischebeth
  • I. Reiter-Owona
  • T. M. Randau
  • S. Gravius
  • N. Gravius
Case Report


Musculoskeletal hydatidosis is a rare but severe disease in central Europe. This case report presents the incidental finding of an osseous hydatidosis after cementless revision total hip arthroplasty in a patient without a preoperative history of hydatidosis or any clinical symptoms. Revision total hip arthroplasty had been necessary due to a septic osteonecrosis of the femoral head 2 years after osteosynthesis of a traumatic proximal femur fracture with a sliding hip screw. The positive sample was taken out of the greater trochanter in the area of the possible former entry point for the lag screw, which was macroscopic inconspicuous. Sero-analysis could afterwards confirm the suspected diagnosis. Postoperative chemotherapy with albendazole was performed for 6 months. A full-body MRI did not reveal any further cysts. This case demonstrates a possible impact of migration on the expected pathogens in revision arthroplasty. This demonstrates that in revision arthroplasty, an infection with this parasite also has to be taken into account, if the patients come from an area endemic for hydatidosis.


Osseous hydatidosis Femur Prothesis Total hip arthroplasty Revision 


Compliance with ethical standards

Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.


  1. 1.
    Brunetti E, Kern P, Vuitton DA. Expert consensus for the diagnosis and treatment of cystic and alveolar echinococcosis in humans. Acta Trop. 2010;114:1–16.CrossRefGoogle Scholar
  2. 2.
    Leslé F, Magrino B, Dupouy-Camet J, Sailhan F. Two cases of femoral hydatidosis secondary to canine tapeworm treated by albendazole and prosthetic reconstruction. BMJ Case Rep. 2013. Scholar
  3. 3.
    Csotye J, Sisák K, Bardócz L, Tóth K. Pathological femoral neck fracture caused by an echinococcus cyst of the vastus lateralis-case report. BMC Infect Dis. 2011;11:103.CrossRefGoogle Scholar
  4. 4.
    Steinmetz S, Racloz G, Stern R, Dominguez D, Al-Mayahi M, Schibler M, Lew D, Hoffmeyer P, Uckay I. Treatment challenges associated with bone echinococcosis. J Antimicrob Chemother. 2014;69:821–6.CrossRefGoogle Scholar
  5. 5.
    Loudiye H, Aktaou S, Hassikou H, Bardouni AE, Manouar ME, Fizazi M, Tazi A, Hajjaj-Hassouni N. Hydatid disease of bone. Jt Bone Spine. 2003;70:352–5.CrossRefGoogle Scholar
  6. 6.
    Paprosky WG, Burnett RSJ. Assessment and classification of bone stock deficiency in revision total hip arthroplasty. Am J Orthop Belle Mead NJ. 2002;31:459–64.Google Scholar
  7. 7.
    Wimmer MD, Randau TM, Petersdorf S, Pagenstert GI, Weißkopf M, Wirtz DC, Gravius S. Evaluation of an interdisciplinary therapy algorithm in patients with prosthetic joint infections. Int Orthop. 2013;37:2271–8.CrossRefGoogle Scholar
  8. 8.
    Santivañez SJ, Sotomayor AE, Vasquez JC, Somocurcio JG, Rodriguez S, Gonzalez AE, Gilman RH, Garcia HH. Absence of brain involvement and factors related to positive serology in a prospective series of 61 cases with pulmonary hydatid disease. Am J Trop Med Hyg. 2008;79:84–8.CrossRefGoogle Scholar
  9. 9.
    Infanger M, Kossmehl P, Grimm D. Surgical and medical management of rare echinococcosis of the extremities: pre- and post-operative long-term chemotherapy. Scand J Infect Dis. 2005;37:954–7.CrossRefGoogle Scholar
  10. 10.
    Zlitni M, Ezzaouia K, Lebib H, Karray M, Kooli M, Mestiri M. Hydatid cyst of bone: diagnosis and treatment. World J Surg. 2001;25:75–82.CrossRefGoogle Scholar
  11. 11.
    Song XH, Ding LW, Wen H. Bone hydatid disease. Postgrad Med J. 2007;83:536–42.CrossRefGoogle Scholar
  12. 12.
    Reuter S, Jensen B, Buttenschoen K, Kratzer W, Kern P. Benzimidazoles in the treatment of alveolar echinococcosis: a comparative study and review of the literature. J Antimicrob Chemother. 2000;46:451–6.CrossRefGoogle Scholar
  13. 13.
    Samadian M, Alavi E, Sharifi G, Rezaee O, Faramarzi F. Extension of echinococcal spinal infestation extra- and intradurally after a decade of extinction. J Neurosurg Sci. 2010;54:143–8.Google Scholar
  14. 14.
    Schmolders J, Koob S, Schepers P, Gravius S, Wirtz D, Burger C, Pennekamp P, Strauss A. The role of a Modular Universal Tumour and Revision System (MUTARS®) in lower limb endoprosthetic revision surgery—outcome analysis of 25 patients. Z Für Orthop Unfallchirurgie. 2016;155:61–6.CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Frank S. Fröschen
    • 1
    Email author
  • H. P. Fischer
    • 2
  • G. T. Hischebeth
    • 3
  • I. Reiter-Owona
    • 3
  • T. M. Randau
    • 1
  • S. Gravius
    • 1
  • N. Gravius
    • 1
  1. 1.Department of Orthopaedics and Trauma SurgeryUniversity Hospital BonnBonnGermany
  2. 2.Department of PathologyUniversity Hospital BonnBonnGermany
  3. 3.Institute of Medical Microbiology, Immunology and ParasitologyUniversity Hospital BonnBonnGermany

Personalised recommendations