Retrieval Technique of a Broken Guidewire During Core Decompression: Bailout Options - A Case Report

Hardware failure during orthopedic procedures is a rare but serious complication. Guidewire breakage, especially during hip surgeries, poses a risk of deep migration, potentially leading to damage to intrapelvic structures. Retrieval of a broken wire from the femoral head or acetabulum carries significant risk, including iatrogenic cartilage damage and injury to pelvic organs.

We report a case of a 19-year-old male presenting with avascular necrosis of bilateral femoral heads (Association Research Circulation Osseous Stage II) who underwent core decompression with platelet-rich plasma injection. The guidewire used broke in the femoral head and migrated into the acetabulum during the surgery, which was successfully retrieved using a combination of over-reaming and an arthroscopic grasper.

Our method effectively retrieved the broken guidewire using a minimally invasive technique. Various bailout options, precautions, and prevention strategies are discussed to aid orthopedic surgeons in managing this complication safely.