Search

Hip arthroplasty is an extremely satisfying treatment method for coxarthrosis which is in increasing use throughout the world. However, loosening of the prosthesis is a significant complication and to overcome this, ceramic liners are increasingly being selected. If the survival of ceramic surfaces is prolonged, there is a risk of fracture of the ceramic materials. New ceramic materials developed to overcome this problem are more resistant. The case presented here is of a patient in whom liner fracture developed following ceramic-ceramic hip arthroplasty. The ceramic femoral head was observed to have protruded into the defect created in the acetabular component. Acetabular revision was applied to the patient.

A 70-year-old female patient presented with left hip arthritis following longstanding painfully restricted hip movement for 2 years. X-rays showed protrusio acetabuli with avascular necrosis of head femur. The patient was operated for hip arthritis; hybrid total hip replacement was done with reconstruction of the medial wall with autologous bone graft of femoral head using stainless steel metal wire mesh on which cemented acetabular component with non-cemented femoral component was fixed. Cages and wire mesh are used to reconstruct the medial wall of acetabulum, but cage is a costlier option than wire mesh, with reproducible results. Very few cases have been reported, showing excellent results with the use of metal wire mesh.

Protrusio acetabuli is a disease characterized by a deformity of the medial wall of the acetabulum with a progressive migration of the femoral head into the pelvic cavity, resulting in some mechanical disorders, pain and limited limb hip movement. It was first described by Otto in 1824 as an intrapelvic protusion of the femoral head. It is considered multifactorial, and it is suggested that there is a heredity background to this disease. It is classified as primary (75,3%) or secundary (24,7%) according to aetiology; mild, moderate and severe radiologically. This review aims to present some treatment techniques using arthroplasties which are several and little explored. As in the literature, the choice was bone graft since there is no migration of the cemented acetabulum and no necessity of a titanium cup of great diameter.