Irreducible dislocated total hip replacement due to intra-articular incarceration of bone cement: A case report

Abstract

Introduction: Dislocation following total hip replacement is a well-documented complication. We present an unusual cause of failure to achieve a concentric closed reduction of a cemented total hip replacement which has never previously been reported.

Presentation of case: A 78-year-old female patient had an unsuccessful closed reduction of a posteriorly dislocated total hip replacement. Careful review of perioperative radiographs revealed a fragment of bone cement incarcerated within the acetabular component blocking reduction. This was confirmed on a subsequent computed tomography scan. Open reduction via a posterior approach with retrieval of the cement fragment was eventually required.

Discussion: Observation of important radiological features which may prevent unnecessary further attempts at closed reduction are discussed. We consider reasons for a non-concentric reduction and reflect on the dangers of multiple forced attempts.

Conclusion: This case emphasises the importance of clinical judgement during closed reduction and highlights a previously unreported cause for non-concentric reduction in a dislocated cemented total hip replacement.

Keywords: Bone cement; Dislocation; Hip replacement; Instability.