Treatment of Bilateral Recurrent Dislocation of Hip Pros-thesis with Malpositioned Well-Fixed Shell: A Case Report

• 作者: Fernando Judas Francisco Lucas Luis Maximino
• 来源期刊: 矫形学期刊(英文)
• 学科: 医学
• 关键词: HIP PROSTHESIS BILATERAL Recurrent Dislocation Malpositioned Well-Fixed SHELL Surgical TREATMENT
• 年，卷（期）: jxxqkyw_2013,（3）
• 页码范围: 172-177
• 页数: 6页
• 分类号: R73

摘要

Dislocations of total hip prostheses cause pain and patient dissatisfaction. Recurrent dislocations are difficult to treat mainly when the acetabular metal shell is well-fixed. The purpose of this article was to describe the surgical technique used for the treatment of a bilateral recurrent posterior dislocation after a cementless total hip prosthesis, caused by excessive inclination of acetabular components, in a 72-year-old patient. On both sides, acetabular metal shell, porouscoated, was well-fixed. Revision of the entire acetabular component could be an appropriate therapeutic option because it was malpositioned. Nevertheless, a conservative operation was performed. The metal shell was left in situ and the preexisting polyethylene liner was removed and replaced by a new undersized cross-linked polyethylene liner, then, cemented into the shell and properly oriented. An acetabular cemented augmentation reinforced by 3 cortical screws was associated with the reconstruction. This report suggests that cementation of new liner into a malpositioned well- fixed metal shell associated with an acetabular cemented augmentation is a simple and safe technique for the management of recurrent hip dislocation, for elderly patients in which it is advisable to avoid a major revision hip surgery by medical comorbidities. Nonetheless, further studies with medium-and long-term follow-up are needed to validate this technique.