Hip Pelvis.  2013 Sep;25(3):220-225. 10.5371/hp.2013.25.3.220.

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

Affiliations
  • 1Department of Orthopaedic Surgery, Chungnam National University School of Medicine, Daejeon, Korea. dshwang@cnu.ac.kr
  • 2Department of Orthopedic Surgery, Busan Bumin Hospital, Busan, Korea.
  • 3Department of Orthopedic Surgery, Seoul Bumin Hospital, Seoul, Korea.

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.

Keyword

Total hip replacement; Screw; Acetabular cup liner; Dissociation

MeSH Terms

Arthroplasty
Arthroplasty, Replacement, Hip*
Hip*
Humans
Noise
Transplants

Figure

  • 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.


Reference

1. Ong KL, Mowat FS, Chan N, Lau E, Halpern MT, Kurtz SM. Economic burden of revision hip and knee arthroplasty in Medicare enrollees. Clin Orthop Relat Res. 2006; 446:22–28.
Article
2. Yoo MC, Cho YJ, Kim KT, Kim KI, Park JY, Hwang DW. Dissociation of the polyethylene liner from the acetabular metal shell. J Korean Hip Soc. 2000; 12:92–101.
3. Rozkydal Z, Janícek P, Smíd Z. Total hip replacement with the CLS expansion shell and a structural femoral head autograft for patients with congenital hip disease. J Bone Joint Surg Am. 2005; 87:801–807.
Article
4. Sporer SM, O'Rourke M, Chong P, Paprosky WG. The use of structural distal femoral allografts for acetabular reconstruction. Average ten-year follow up. J Bone Joint Surg Am. 2005; 87:760–765.
Article
5. Willert HG, Semlitsch M. Reactions of the articular capsule to wear products of artificial joint prostheses. J Biomed Mater Res. 1977; 11:157–164.
Article
6. Sedel L. Evolution of alumina-on-alumina implants: a review. Clin Orthop Relat Res. 2000; (379):48–54.
7. Moon DH, Choi JS, Kim DW, Kim KH. Ceramic on ceramic total hip arthroplasty: the results of a minimum 10-years follow up. J Korean Hip Soc. 2011; 23:116–123.
Article
8. Lee JM, Roh JY, Park YS. Results of revision hip arthroplasty using cemented femoral stem. J Korean Hip Soc. 2007; 19:472–478.
Article
9. Spangehl MJ, Berry DJ, Trousdale RT, Cabanela ME. Uncemented acetabular components with bulk femoral head autograft for acetabular reconstruction in developmental dysplasia of the hip: results at five to twelve years. J Bone Joint Surg Am. 2001; 83-A:1484–1489.
10. Hooten JP Jr, Engh CA Jr, Engh CA. Failure of structural acetabular allografts in cementless revision hip arthroplasty. J Bone Joint Surg Br. 1994; 76:419–422.
Article
11. Hwang KT, Kim YH. Revision total hip arthroplasty of an acetabular cup with acetabular bone defects. J Korean Hip Soc. 2011; 23:237–247.
Article
Full Text Links
  • HP
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr