Acetabular Fracture after Hip Hemiarthroplasty: One Stage Procedure to a Total Hip Arthroplasty after Stabilization of the Fracture by Means of Cerclage Wires

J Orthop Case Rep. 2017 Nov-Dec;7(6):20-23. doi: 10.13107/jocr.2250-0685.932.

Abstract

Introduction: Hip fractures in the elderly pose an increasing problem in society. In the elderly, a bipolar hemiarthroplasty (HA) remains the treatment of choice in case of hip fractures related to osteoporosis. However, due to an ongoing osteoporosis in this age group, a periprosthetic femoral fracture and a fracture of the unresurfaced acetabulum are increasingly noticed.In the literature, no information can be found regarding the treatment options for this kind of periprosthetic acetabular fracture.

Case report: We present a case report of a patient suffering an acetabular fracture 6 years after a HA. A one stage surgical procedure was the treatment of choice, consisting of a stabilization the acetabulum fracture by means of cerclage wires and a conversion of the HA to a total hip arthroplasty (THA). 4 months after surgery, she regained her pre-operative functional status, and a radiographic evaluation of the right hemipelvis showed good signs ofthe fracture healing without migration ofthe acetabular component.

Conclusion: This case shows a "one stage" surgery solution for an acetabular fracture after HA. Stabilization of the acetabulum fracture by means of cerclage wires and a conversion ofthe HA to a THAis a viable solution for this rare and challenging problem.

Keywords: Hemiarthroplasty; acetabular fracture; cerclage wires.

Publication types

  • Case Reports