Two-Stage Management of Early Intrapelvic Cup Migration

Intrapelvic migration of the acetabular component following hip arthroplasty is a rare but challenging complication with significant risks, including adjacent organs and vascular injury. In the current literature, managing this complication has focused on removing the migrated failed implant first, followed by revision of the prosthesis. We present the case of a patient who sustained an early intrapelvic migration of the acetabular cup and screws following total hip arthroplasty. A unique two-stage approach was employed: acetabular reconstruction using bone graft, a Kerboull cross-plate, and a dual-mobility cup was performed first; the migrated cup and screws were safely removed subsequently through a retroperitoneal approach. The described technique highlights the efficacy of a staged surgical intervention, starting with the acetabular reconstruction, followed by delayed removal of the retained intrapelvic implant.