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Total Hip Replacement Interrupted by Intraoperative Arrest with a Final Component in Place: A Case Report.

Mitchell Stephen Fourman¹, Nina Singh², Patrick J McMahon¹

¹Orthopaedic Surgery Service Department of Surgery VA Pittsburgh Medical Center Pittsburgh, PA USA.

The Archives of Bone and Joint Surgery

|October 19, 2022

Summary

This case report details managing an exposed acetabular implant during an interrupted total hip arthroplasty (THA) due to cardiac arrest. The implant was successfully retained and the procedure completed later, with the patient recovering well.

Keywords:

Antibiotic prophylaxis Arthroplasty Contaminated implants Intraoperative arrest

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Individualized Stem-positioning in Calcar-guided Short-stem Total Hip Arthroplasty

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Published on: February 27, 2018

Area of Science:

Orthopedic Surgery
Cardiovascular Medicine
Infectious Disease Management

Background:

No established guidelines exist for managing exposed implants during interrupted total hip arthroplasty (THA).
Single case reports are valuable for informing clinical decisions in rare surgical scenarios.

Observation:

A 71-year-old male undergoing THA experienced ventricular fibrillation after acetabular component placement.
The THA was aborted, the acetabular implant retained, and the patient resuscitated.
The arthroplasty was successfully completed 6 hours later with the original implant.

Findings:

The patient received prophylactic antibiotics (vancomycin and doxycycline) and healed without complications.
Retaining the acetabular implant in this emergent situation was feasible and led to an uneventful recovery.

Implications:

This case provides a potential management template for similar rare intraoperative emergencies during THA.
Further documentation of such events can help establish best practices for implant management in critical situations.