Revision Hip Arthroplasty After Acetabular Cup Protrusion

Abstract

Acetabular protrusion after total hip arthroplasty is considered to be produced by an acetabular defect resulting from the displacement of the acetabular cup medially. The most frequent cause, a fractured medial wall, can lead to important impediments in performing revision total hip arthroplasty (RTHA). When it comes to an anterior hip replacement that requires revision, it may need a different approach. This case suggests an intersting alternative in the management of these rare and problematic pathologies. We would like to present the case of an acetabular fracture with a protrusion at the level of the acetabulum in a 52-year-old patient following a falling trauma from the same level and which presented itself one year after the trauma. The surgical intervention consisted in extracting the acetabular cup and reaming the acetabular fossa, filling the remaining defect with bone graft and bone cement, and then applying a semi-retentive cemented cup. The recovery was complete and uneventful. Thus, although it is known that acetabular protrusion can occur in rarer cases in people with a total hip prosthesis, we want to increase attention to this complication. A thorough initial assessment must be performed to identify the patients who may require stabilization of the pelvic ring.