Avascular Necrosis of the Femoral Head Managed with Total Hip Arthroplasty in a Patient with Lymphatic Filariasis: A Case Report

Lymphatic filariasis is one of the major issues in public health in endemic regions. This tropical disease is caused by mosquitoborne parasites such as Wuchereria bancrofti, Brugia malayi, and Brugia timori and predominantly targets the lymphatic system, causing limb dysfunction and other complications. It is clinically noted as lymphoedema, swelling, pain and fever. This is a case of a 52-year-old male farmer from an endemic region with chronic lymphoedema and progressive right hip pain. He presented to the Outpatient Department with complaints of pain in right hip and swelling in left lower limb. Initially, the patient experienced a dull, aching pain in the right hip. The pain was persistent throughout the day, relieved with rest and exacerbated on walking and weight-bearing activities. The pain progressively worsened, eventually leading to significant difficulty in moving the left lower limb. Radiological evaluation revealed avascular necrosis of the femoral head of the right hip, for which the patient subsequently underwent right-sided-total hip arthroplasty. The diagnosis of lymphatic filariasis involving the left lower limb was confirmed by serological testing, and appropriate medical management was initiated. This case highlights an unusual orthopaedic manifestation of lymphatic filariasis requiring hip arthroplasty, rarely reported in literature.