Surgical Strategy in Intra-pelvic Cup Migration During Total Hip Arthroplasty. A Case Study

We report the case of a 63-year-old female patient referred to our department due to an early postoperative complication resulting from intraoperative fault. During the preparation of a bone socket for the acetabular cup, the acetabular fossa was broken, forming an extensive segmental defect of the diameter of the reamer used. An attempt to stabilize the acetabular prosthesis using bone cement without repairing the bone defect was ineffective and inappropriate. During the deposition of the acetabular prosthesis on the cement, much of the cement was pushed beyond the outline of the bony acetabulum. Progressive early migration of the acetabular cup together with the cement due to the non-implementation of rapid intervention led to their displacement into the abdominal cavity. On analysing a radiograph performed 3 months after the operation, we decided to adopt a two-stage surgical strategy. In the first stage, the acetabular prosthesis with the cement was removed from a retroperitoneal approach. Three weeks later a revision arthroplasty of the acetabular component was carried out with reconstruction of the acetabular floor.