Irreducible dislocated total hip replacement due to intra-articular incarceration of bone cement: A case report

Dislocation following total hip replacement is a well-documented complication. We present an unusual cause of failure to achieve a concentric closed reduction of a cemented total hip replacement which has never previously been reported.

A 78-year-old female patient had an unsuccessful closed reduction of a posteriorly dislocated total hip replacement. Careful review of perioperative radiographs revealed a fragment of bone cement incarcerated within the acetabular component blocking reduction. This was confirmed on a subsequent computed tomography scan. Open reduction via a posterior approach with retrieval of the cement fragment was eventually required.

Observation of important radiological features which may prevent unnecessary further attempts at closed reduction are discussed. We consider reasons for a non-concentric reduction and reflect on the dangers of multiple forced attempts.

This case emphasises the importance of clinical judgement during closed reduction and highlights a previously unreported cause for non-concentric reduction in a dislocated cemented total hip replacement.