Intrapelvic Migration of Prosthetic Femoral Head after Revision Total Hip Arthroplasty - A Case Report

Intrapelvic migration of the femoral head is a rare complication of total hip arthroplasty (THA).

A 54-year-old Caucasian female was submitted to revision THA. She suffered an anterior dislocation and avulsion of the prosthetic femoral head that required open reduction. Intraoperatively, the femoral head migrated into the pelvis, along the psoas aponeurosis. The migrated component was retrieved on a subsequent procedure, through an anterior approach to the iliac wing. The patient had a good post-operative course and 2 years after surgery she has no complains related to this complication.

Most of the cases described in the literature are of intraoperative migration of trial components. The authors found only one case described involving a definitive prosthetic head, but during primary THA. No case was found due to post-operative dislocation or definitive femoral head migration after revision surgery. Due to the lack of long-term studies of intra pelvic implant retention, we recommend to remove these implants, particularly in younger patients.