Anterior Hip Dislocation Following Total Hip Arthroplasty, Caused by Broken Trial Femoral Head Particles: A Case...

Dislocation is one of the most common causes of patient and surgeon dissatisfaction following total hip arthroplasty (THA). In this case, we describe the presence of broken plastic particles, originating from the plastic trial femoral head (TFH) which caused total hip dislocation.

A 67-year-old man with avascular necrosis of his left hip, who underwent a hybrid THA, dislocated his hip twice in the first 2 months after the initial surgery. A computed tomography scan revealed a well-oriented cup and stem and the presence of two dense intra-articular particles, later identified as the possible cause of dislocation. The particles were removed during revision surgery and were retrospectively determined to be broken TFH particles, made of hard plastic.

We believe that the brittle design of certain TFH components is vulnerable to damage during perioperative trialing and testing; therefore, care must be taken to check the integrity of these devices during hip surgery. It is important to recognize the existence of such a rare complication.