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Traumatic Floating Total Hip Arthroplasty: A Case Report
James D Brodell1, Jared M Newman1, Sandeep P Soin2
1Department of Orthopaedics and Physical Performance, University of Rochester Medical Center, Rochester, New York.
JBJS Case Connector
|May 10, 2024
Summary
A rare hip fracture occurred in a patient with a prior total hip arthroplasty. This case of Vancouver C periprosthetic femur and pelvic fracture offers insights for managing similar complex hip injuries.
Area of Science:
- Orthopedic Surgery
- Trauma Surgery
- Arthroplasty
Background:
- Total hip arthroplasty (THA) is a common procedure.
- Periprosthetic fractures are a known complication of THA.
- The direct anterior (DA) approach is a surgical technique for THA.
Purpose of the Study:
- To report a unique case of combined periprosthetic femur and pelvic fracture after THA.
- To describe the injury pattern in relation to the hip implant.
- To provide potential guidance for future treatment strategies.
Main Methods:
- Case report of a 58-year-old woman with a history of left THA via the DA approach.
- Diagnosis of transverse Vancouver C periprosthetic femur fracture and unstable periprosthetic pelvic fracture.
- Clinical and radiographic assessment of the injury.
Main Results:
- The patient sustained a complex fracture pattern distal to the femoral implant and proximal to the acetabular implant.
- The implant-to-bone interface remained unaffected.
- This represents a previously unreported injury associated with total hip arthroplasty.
Conclusions:
- This case highlights a rare and complex injury scenario following THA.
- The unaffected implant-to-bone interface in this specific fracture pattern is noteworthy.
- Understanding this injury may inform surgical decision-making and management for similar cases.
