Aseptic Acetabular Protrusio with Intrapelvic Migration of a Bipolar Prosthesis: A Case Report of a Rare Presentation and its Management
Journal Title: Kerala Journal of Orthopaedics - Year 2018, Vol 0, Issue 0
Abstract
Introduction: Bipolar hemiarthroplasty is a very common surgery done for geriatric patients with femoral neck as well as some trochanteric fractures. Complications usually range from infection, loosening, and dislocation to periprosthetic fractures. We present here a case report of a very rare presentation of aseptic acetabular protrusio with intrapelvic migration of a bipolar prosthesis and how it was managed. Case Report: An 80-year-old male patient of Indian origin operated with bipolar hemiarthroplasty 4 years back presented with severe pain and restricted movements of the right hip. The patient was having progressive pain for the past 1 year with a history of sudden giving way while walking 1 month back. Radiographs and further imaging showed acetabular protrusio of the bipolar prosthesis with intrapelvic migration of the head. There was no evidence of infection seen on investigations and hip aspiration. Surgery was associated with high risk due to the associated comorbidities and the close proximity of neurovascular structures to the prosthesis. The patient was managed with extended trochanteric osteotomy, implant removal, and revision total hip arthroplasty with antiprotrusio cage and long revision stem in a single stage. At 18-months follow-up, the patient is walking well without support. Conclusion: An elderly patient with multiple comorbidities and with the bipolar prosthesis lodged in the pelvis could be managed well with an excellent functional outcome. However, proper pre-operative planning with all required implants and instruments with a backup plan remains the key in such complicated and rare presentations.
Authors and Affiliations
Nibu M Kurian, M J Joice Varghese, G Divya G Divya, S Dileep S Dileep, John T John John T John
Keywords
Related Articles
- EP ID EP573008
- DOI -
- Views 40
- Downloads 0
Comparison of Efficacy of Intra Operative Periarticular Injection With That of Post Operative Epidural Analgesia for Pain Control Following Unilateral Total Knee Arthroplasty Under Spinal Anesthesia — A Prospective Randomized Controlled Trial
Objective: To compare the efficacy of intra operative periarticular injection with that of post operative epidural analgesia for pain control following unilateral total knee arthroplasty under spinal anesthesia with rega...
Atypical Guillain-Barre Syndrome in a known Case of Lumbar Canal Stenosis – A Clinical Dilemma
Introduction: Guillian Barre is an autoimmune syndrome characterised by acute inflammatory demyelinating polyneuropathy.Patients suffering from GBS typically have pain,numbness,paraesthesia and weakness in upper limbs an...
Subacromial Bursal Chondromatosis in a Patient with Rheumatoid Arthritis
Introduction: A 51-year-old female, known rheumatoid arthritis patient, presented with soft fluctuant painful swelling of her left shoulder of 4 months duration. Imaging findings are presented which suggested subacromial...
A Rare Presentation of Aneurysmal Bone Cyst – Calcaneum
Introduction: Aneurysmal bone cysts are a benign non-neoplastic reactive bone lesion filled with multiple blood-filled cavities, can be locally destructive to normal bone, and may extend to soft tissue. It is usually se...
Periprosthetic Joint Infections: Current Concepts
Periprosthetic joint infection(PJI) is a disaster, the most dreaded complication of any arthroplasty. Different series mention different rates of infection ranging from 1.6% to 7% across primary and revision TJA’s. Singl...