Liner Dissociation by Extrusion of the Acetabular Cup Fixation Screw after Total Hip Replacement: Two Cases Report

Yoo-Sun Jeon; Deuk-Soo Hwang; Chan Kang; Pil-Sung Kim; Jung-Mo Hwang; Jae-Hwang Song

doi:10.5371/hp.2013.25.3.220

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Jeon, Hwang, Kang, Kim, Hwang, and Song: Liner Dissociation by Extrusion of the Acetabular Cup Fixation Screw after Total Hip Replacement: Two Cases Report

Case Report

Hip & Pelvis 2013; 25(3): 220-225.

Published online: 30 September 2013

DOI: https://doi.org/10.5371/hp.2013.25.3.220

Liner Dissociation by Extrusion of the Acetabular Cup Fixation Screw after Total Hip Replacement: Two Cases Report

Yoo-Sun Jeon, MD^*, Deuk-Soo Hwang, MD, Chan Kang, MD, Pil-Sung Kim, MD^†, Jung-Mo Hwang, MD, Jae-Hwang Song, MD

Department of Orthopaedic Surgery, Chungnam National University School of Medicine, Daejeon, Korea.

^*Department of Orthopedic Surgery, Busan Bumin Hospital, Busan, Korea.

^†Department of Orthopedic Surgery, Seoul Bumin Hospital, Seoul, Korea.

Address reprint request to Deuk-Soo Hwang, MD. Department of Orthopedic Surgery, Chungnam National University School of Medicine, 33 Munwha-ro, Jung-gu, Daejeon 301-846, Korea. TEL: +82-42-280-7350, FAX: +82-42-252-7098, dshwang@cnu.ac.kr

Received 17 April 2013 Revised 29 August 2013 Accepted 29 August 2013

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

This is a report of 2 cases that showed dissociation of the acetabular cup liner by acetabular fixation screw among patients who underwent total hip replacement. Screws for fixation of the acetabular cup were used during the primary surgery in both cases. Each patient visited the out patient department complaining of pain and noise from the joint; radiologic finding revealed a collapse of the column shape bone graft area with dissociation of the acetabular cup liner. In both cases, during revision surgery, screw was extruded to the inner side of the acetabular cup, since it migrated superiorly. There has been no report of liner dissociation by extrusion of acetabular cup fixation screw after total hip replacement. Therefore, we report two cases of dissociation of the acetabular cup liner of hip arthroplasty, which occurred due to screw issues after total hip replacement with structural autogenous bone graft.

Keywords: Total hip replacement, Screw, Acetabular cup liner, Dissociation

Figures and Tables

Fig. 1

51-year-old male underwent structural autogenous bone graft and ceramic on ceramic total hip replacement for post-traumatic arthritis of the left hip. (A) Immediate postoperative radiographs show the well fixed acetabular cup. (B1) Anteroposterior radiograph at 29 months postoperatively shows 8 mm collapse of acetabular bone graft site and ceramic liner dissociation (arrow). (B2) CT shows screw extrusion into the inner side of acetabular cup and ceramic liner dissociation due to the compression by the extruded screw (arrow). (C1) Scratch was seen on the surface of the ceramic liner and head. (C2) Screw was extruded into the inner side of acetabular cup without loosening (arrow).

Fig. 2

51-year-old female underwent structural autogenous bone graft and metal on metal total hip replacement for secondary arthritis with dysplasia of the right hip. (A) Immediate postoperative radiographs show the well fixed acetabular cup. (B1) Anteroposterior radiograph at 8 months postoperatively shows 9mm collapse of acetabular bone graft site and metal liner dissociation (arrow). (B2) CT shows screw extrusion into the inner side of acetabular cup and metal liner dissociation due to the compression by the extruded screw (arrow). (C1) Screw was extruded to the inner side of acetabular cup with loosening (arrow). (C2) Scratch was seen over the metal liner. (C3) Screw head was worn-out.

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