Exchange and Reorientation of an Elevated-rim Polyethylene Liner for the Recurrent Anterior Subluxation after Total Hip Arthroplasty - A Case Report -

Nam Hoon Moon; Won Chul Shin; Kuen Tak Suh

doi:10.5371/hp.2013.25.4.286

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Moon, Shin, and Suh: Exchange and Reorientation of an Elevated-rim Polyethylene Liner for the Recurrent Anterior Subluxation after Total Hip Arthroplasty - A Case Report -

Case Report

Hip & Pelvis 2013; 25(4): 286-291.

Published online: 31 December 2013

DOI: https://doi.org/10.5371/hp.2013.25.4.286

Exchange and Reorientation of an Elevated-rim Polyethylene Liner for the Recurrent Anterior Subluxation after Total Hip Arthroplasty - A Case Report -

Nam Hoon Moon, MD, Won Chul Shin, MD, Kuen Tak Suh, MD

Department of Orthopaedic Surgery, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea.

Address reprint request to Kuen Tak Suh, MD. Department of Orthopaedic Surgery, Pusan National University Yangsan Hospital, 20 Geumo-ro, Mulgeum-eup, Yangsan 626-770, Korea. TEL: +82-55-360-2125, FAX: +82-55-360-2155, kuentak@pusan.ac.kr

Received 1 October 2013 Revised 13 December 2013 Accepted 13 December 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

Total hip arthroplasty for osteoarthritis of the right hip was performed in a 62-year-old female patient with right-side weakness due to cerebral infarction. Because the second cerebral infarction aggravated right-side weakness, recurrent anterior subluxation occurred two years after surgery. We report on a case of recurrent anterior subluxation of total hip arthroplasty, which was treated successfully by exchange and reorientation of an elevated-rim polyethylene, and discuss studies reporting on recurrent subluxation after total hip arthroplasty and its treatment.

Keywords: Total hip arthroplasty, Recurrent subluxation, Polyethylene reorientation

Figures and Tables

Fig. 1

Radiographs illustrate the case of a 62-year-old woman who underwent the cementless total hip arthroplasty. (A) Anteroposterior radiograph demonstrates the inclination and the anteversion of cup. The inclination is defined as the angle between the inter-tear drop line and the long axis of the ellipse which is formed by the window opening of the cup. The anteversion is measured according to Liaw's method1). The shaft axis of the ellipse "S" and the total length "TL" of the projected cross-section of the cup along the short axis is measured. (B) Translateral radiograph shows the position of the component.

Fig. 2

After 12 days of primary total hip arthroplasty, (A) anteroposterior and (B) translateral radiographs show the anterior dislocation.

Fig. 3

Retrieved polyethylene demonstrates wears in the 9 o'clock direction (black arrow) due to the impingement between the neck of femoral component and elevated rim and in the 3 o'clock direction (white arrow) due to recurrent anterior subluxation of femoral head.

Fig. 4

Postoperative (A) anteroposterior and (B) translateral radiographs of the right hip show that the component is acceptable position.

Fig. 5

5 years follow-up (A) anteroposterior and (B) translateral radiographs of the right hip show that the component is stable with no evidence of loosening and subluxation.

References

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