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

• Jeon YS
• Hwang DS
• Kang C
• Kim PS
• Hwang JM
• Song JH

• KMID: 1974378
• DOI: http://doi.org/10.5371/hp.2013.25.3.220

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.

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