Dual mobility total hip dislocation-femoral stem loosening while attempting closed reduction: a cautionary note

Area of Science:

• Orthopaedic Surgery
• Traumatology
• Arthroplasty

Background:

• Acetabular fractures require complex surgical management.
• Dual mobility total hip arthroplasty (THA) is an option for managing acetabular fractures with associated hip instability.
• Postoperative complications, such as dislocation, can occur.

Observation:

• A 77-year-old male with an acetabular fracture underwent open reduction, internal fixation, and dual mobility THA.
• One month postoperatively, the patient experienced a traumatic hip dislocation.
• A subsequent closed reduction attempt resulted in femoral stem dislodgement.

Findings:

• The dislocation was suspected to be caused by polyliner hitching.
• Dual mobility THA dislocations are difficult to diagnose on standard radiography.
• Radiographic visualization of the polyliner is often obscured, complicating diagnosis.

Implications:

• Orthopaedic surgeons must be aware of the diagnostic challenges associated with dual mobility THA dislocations.
• Careful reduction techniques are crucial to avoid exacerbating complications.
• This case highlights the need for vigilance in managing hip dislocations after dual mobility THA in acetabular fracture patients.