Volume 5, Issue 1, Pages 5-10 (March 2019)

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Presentation transcript:

Volume 5, Issue 1, Pages 5-10 (March 2019) Gross trunnion failure after a metal-on-polyethylene total hip arthroplasty leading to dissociation at the femoral head-trunnion interface Surajudeen A. Bolarinwa, MD, John M. Martino, MD, Joseph T. Moskal, MD, Michael W. Wolfe, MD, Thomas E. Shuler, MD Arthroplasty Today Volume 5, Issue 1, Pages 5-10 (March 2019) DOI: 10.1016/j.artd.2019.02.001 Copyright © 2019 The Authors Terms and Conditions

Figure 1 Preoperative anteroposterior (a) and frog leg lateral (b) radiographs of the right hip from September 2008 demonstrating severe osteoarthritis of the right hip. Arthroplasty Today 2019 5, 5-10DOI: (10.1016/j.artd.2019.02.001) Copyright © 2019 The Authors Terms and Conditions

Figure 2 Postoperative anteroposterior pelvis radiograph from September 2008 after right total hip arthroplasty. Arthroplasty Today 2019 5, 5-10DOI: (10.1016/j.artd.2019.02.001) Copyright © 2019 The Authors Terms and Conditions

Figure 3 Anteroposterior pelvis (a) and lateral hip radiographs (b) from January 2018 demonstrating hardware failure consistent with dissociation at the right femoral head-stem interface. Left total hip arthroplasty was performed on 03/2017 by a different surgeon. Arthroplasty Today 2019 5, 5-10DOI: (10.1016/j.artd.2019.02.001) Copyright © 2019 The Authors Terms and Conditions

Figure 4 Intraoperative images from the revision right total hip arthroplasty in February 2018. (a) Posterolateral surgical approach to the right hip with obvious metallosis in the hip joint and the soft tissues surrounding the implants. Notable is the dislocated CoCr femoral head that the instrument is pointing to. (b) Evidence of wear on the polyethylene liner from the femoral stem after dissociation of the head. (c) Fractured polyethylene liner. (d) Explanted components with significant wear noted about the trunnion to the point that the trunnion was elliptical instead of cylindrical, and on the polyethylene with notable fracture of the liner. (e) End-on view of the worn trunnion. Arthroplasty Today 2019 5, 5-10DOI: (10.1016/j.artd.2019.02.001) Copyright © 2019 The Authors Terms and Conditions

Figure 5 (a) Postoperative anteroposterior pelvis radiograph showing the reconstruction with a modular femoral stem, cables, and greater trochanteric hook plate. (b) Postoperative anteroposterior and lateral radiographs of the right hip from February 2018 after revision right total hip arthroplasty. Arthroplasty Today 2019 5, 5-10DOI: (10.1016/j.artd.2019.02.001) Copyright © 2019 The Authors Terms and Conditions

Figure 6 Anteroposterior (a) and lateral (b) radiograph of the right hip from August 31, 2018, showing maintenance of good alignment of all the hardware, good interval healing, and no complicating features. Arthroplasty Today 2019 5, 5-10DOI: (10.1016/j.artd.2019.02.001) Copyright © 2019 The Authors Terms and Conditions