Hip Pelvis.  2017 Jun;29(2):133-138. 10.5371/hp.2017.29.2.133.

Dissociation of Polyethylene Liner of the Dual Mobility Acetabular Component after Closed Reduction of Dislocation: A Case Report

• Rhyu KH
• Bae CI
• Nam JH
• Bae JG
• Cho YJ
• Chun YS

• KMID: 2424242
• DOI: http://doi.org/10.5371/hp.2017.29.2.133

Abstract

A dual mobility acetabular component has a structure that combines a polyethylene liner and a femoral head, unlike the general design of acetabular cups, making the dissociation of a polyethylene liner highly unlikely. In addition, it increases the range of motion and reduces the possibility of dislocations by increasing a jump distance. A fifty-one-year-old male who had received total hip arthroplasty with the dual mobility acetabular component visited a hospital for a posterior hip dislocation 10 weeks after the operation. At the emergency room, closed reduction was performed and the dislocation was reduced. However, plain imaging test revealed polyethylene liner dissociation after the closed reduction. Revision surgery was performed. We will report a rare case of early dislocation of the dual mobility acetabular component and dissociation of polyethylene liner accompanied with a literature review.

Keyword

Femur head; Hip joint; Hip dislocation; Hip prosthesis; Polyethylene

MeSH Terms

Acetabulum*
Arthroplasty, Replacement, Hip
Dislocations*
Emergency Service, Hospital
Femur Head
Head
Hip Dislocation
Hip Joint
Hip Prosthesis
Humans
Male
Polyethylene*
Range of Motion, Articular
Polyethylene

Figure

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  Fig. 1 A dual mobility acetabular hip implant has a bigger hemispherical polyethylene (PE) liner than an acetabular cup, causing its PE liner opening to be smaller than the diameter of a femoral head.

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  Fig. 2 Anterior-posterior (A) and translateral (B) views of both hip joints shows left femur neck fracture.

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  Fig. 3 Total hip arthroplasty was performed using an dual mobility acetabular component.

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  Fig. 4 Ten weeks from the surgery, posterior dislocation of the left hip joint was observed at the emergency department after slip down on anterior-posterior (A) and translateral (B) views of the hip joints.

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  Fig. 5 After closed reduction of the dislocated hip joint, an eccentric position of the femoral head and the dissociation of polyethylene (PE) liner was observed in soft tissue (arrow) on anterior-posterior (A) and translateral (B) radiographs. The images of hip computed tomography. On the axial (C) and coronal (D) views, dissociated PE liner (arrows) was evident in the left gluteus maximus muscles.

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  Fig. 6 Injured articular surfaces of acetabular inner surface (white arrows) and femoral head (black arrow) were observed at removed aceatbular component and femoral head.

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  Fig. 7 Anterior-posterior (A) and translateral (B) views of both hip joints after revision total hip arthroplasty

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  Fig. 8 Insert device for assemble polyethylene liner with femoral head.

Reference

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