Journal List > Hip Pelvis > v.25(4) > 1081998

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 -

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.

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.
hp-25-286-g001
Fig. 2
After 12 days of primary total hip arthroplasty, (A) anteroposterior and (B) translateral radiographs show the anterior dislocation.
hp-25-286-g002
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.
hp-25-286-g003
Fig. 4
Postoperative (A) anteroposterior and (B) translateral radiographs of the right hip show that the component is acceptable position.
hp-25-286-g004
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.
hp-25-286-g005

References

1. Liaw CK, Yang RS, Hou SM, Wu TY, Fuh CS. Measurement of the acetabular cup anteversion on simulated radiographs. J Arthroplasty. 2009; 24:468–474.
crossref
2. Charnley J. Low friction arthroplasty of the hip: theory and practice. 1st ed. New York: Springer;1979.
3. Cobb TK, Morrey BF, Ilstrup DM. The elevated-rim acetabular liner in total hip arthroplasty: relationship to postoperative dislocation. J Bone Joint Surg Am. 1996; 78:80–86.
4. Bosco JA, Benjamin JB. Loosening of a femoral stem associated with the use of an extended-lip acetabular cup liner. A case report. J Arthroplasty. 1993; 8:91–93.
crossref
5. Murray DW. Impingement and loosening of the long posterior wall acetabular implant. J Bone Joint Surg Br. 1992; 74:377–379.
crossref
6. Graham GP, Jenkins AI, Mintowt-Czyz W. Recurrent dislocation following hip replacement: brief report. J Bone Joint Surg Br. 1988; 70:675.
crossref
7. Lewinnek GE, Lewis JL, Tarr R, Compere CL, Zimmerman JR. Dislocations after total hip-replacement arthroplasties. J Bone Joint Surg Am. 1978; 60:217–220.
crossref
8. Saadat E, Diekmann G, Takemoto S, Ries MD. Is an algorithmic approach to the treatment of recurrent dislocation after THA effective? Clin Orthop Relat Res. 2012; 470:482–489.
crossref
9. Lachiewicz PF, Soileau E, Ellis J. Modular revision for recurrent dislocation of primary or revision total hip arthroplasty. J Arthroplasty. 2004; 19:424–429.
crossref
TOOLS
Similar articles