Extended Trochanteric Osteotomy as a Tool in the Revision of Hip Arthroplasty Due to Aseptic Loosening

Aseptic loosening of femoral and acetabular components is a common complication following total hip arthroplasty (THA). It presents a significant diagnostic and therapeutic challenge for orthopedic surgeons, as it requires differentiation from infection and often necessitates complex revision surger...

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Bibliographic Details
Published in:Curēus (Palo Alto, CA) CA), 2024-10, Vol.16 (10), p.e71557
Main Authors: Gutiérrez-Jiménez, René, Delgado-Cantú, Felipe, González Rivera, Carlos E, Monroy-Quiroz, Alan, Pons-Faudoa, Fernanda P
Format: Article
Language:English
Subjects:
Biopsy
Cement
Fractures
Infections
Joint surgery
Medical imaging
Orthopedics
Pain
Patients
Pelvis
Polyethylene
Prostheses
Sports Medicine
Transplants & implants
Trauma
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Summary:Aseptic loosening of femoral and acetabular components is a common complication following total hip arthroplasty (THA). It presents a significant diagnostic and therapeutic challenge for orthopedic surgeons, as it requires differentiation from infection and often necessitates complex revision surgery. We present the case of a 76-year-old female with a surgical history of total right hip arthroplasty performed one year prior. The patient presented with pain and limited mobility in the right lower extremity. Laboratory studies, including inflammatory markers and cultures, were negative for local or systemic infection. A biopsy of the right hip confirmed the absence of infection. Given these findings, a diagnosis of aseptic loosening was made. A revision right hip arthroplasty was undertaken, during which the acetabular component was found to be intact and was therefore retained. New femoral components were placed using an extended trochanteric osteotomy approach. Postoperatively, the patient demonstrated significant clinical improvement, regaining the ability to walk without support and exhibiting improved range of motion in the affected limb. Aseptic loosening of THA often requires revision surgery with component exchange to avoid any further complications that can increase morbidity and mortality. This produces a diagnostic and therapeutic challenge for the orthopedic surgeon due to the difficulty of cement retraction, previous implants, and the placement of new prosthetic components. Extended trochanteric osteotomy is an excellent tool for the orthopedic surgeon facing a revision of THA to remove the cement mantle and femoral stem and avoid complications.
ISSN:2168-8184
2168-8184
DOI:10.7759/cureus.71557