Hip Pelvis.  2013 Dec;25(4):286-291. 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

• Moon NH
• Shin WC
• Suh KT

• KMID: 1808137
• DOI: http://doi.org/10.5371/hp.2013.25.4.286

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.

Keyword

Total hip arthroplasty; Recurrent subluxation; Polyethylene reorientation

MeSH Terms

Arthroplasty, Replacement, Hip*
Cerebral Infarction
Female
Hip
Humans
Middle Aged
Osteoarthritis
Polyethylene*
Polyethylene

Figure

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  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.

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  Fig. 2 After 12 days of primary total hip arthroplasty, (A) anteroposterior and (B) translateral radiographs show the anterior dislocation.

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  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.

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  Fig. 4 Postoperative (A) anteroposterior and (B) translateral radiographs of the right hip show that the component is acceptable position.

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  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.

Reference

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