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Intra-abdominal removal of a displaced hip prosthesis
Rory Morrison1, Sam Adegbola1, Vish Bhattacharya1
1Queen Elizabeth Hospital, Sheriff Hill, Gateshead NE9 6SX, UK.
International Journal of Surgery Case Reports
|December 16, 2014
Summary
Intra-pelvic hip prosthesis displacement is a rare complication. This case highlights a trans-abdominal approach for safe removal and reconstruction, emphasizing pre-operative planning and vascular surgical collaboration.
Area of Science:
- Orthopaedic Surgery
- Surgical Complications
- Pelvic Anatomy
Background:
- Intra-pelvic hip prosthesis displacement is an uncommon but serious complication after hip arthroplasty.
- This complication can lead to significant patient morbidity.
Purpose of the Study:
- To present a case of intra-pelvic hip prosthesis displacement.
- To highlight the importance of pre-operative planning and surgical approach selection.
- To discuss management strategies for this rare complication.
Main Methods:
- A 69-year-old female with developmental hip dysplasia experienced prosthesis displacement into the pelvis post-total hip replacement.
- A combined vascular and orthopaedic surgical procedure was performed.
- A trans-abdominal approach with laparotomy was utilized for prosthesis removal and hip reconstruction with a cup cage construct and pelvic plate fixation.
Main Results:
- Successful removal of the displaced hip prosthesis.
- Reconstruction of the hip joint and pelvic column.
- Management of potential vascular complications through combined surgical expertise.
Conclusions:
- Intra-pelvic hip prosthesis displacement requires careful pre-operative imaging (e.g., CT scans) to delineate anatomy.
- A trans-abdominal approach offers enhanced visualization and control of pelvic structures for prosthesis removal.
- Collaboration with vascular surgeons is recommended for managing potential vascular injury during this complex procedure.
