REVISION HIP ARTHROPLASTY FOR A CASE OF PROTRUSIO ACETABULI PROSTHETICA WITH PAPROSKY TYPE III ACETABULAR DEFECT A CASE REPORT

Protrusion of the acetabular cup after a total hip arthroplasty is a rare condition and has serious complications. Aseptic loosening of cup with acetabular defects and protrusio needs a safe surgical strategy to reconstruct the acetabular wall and revision of components. We report a case of a 48 year old female who presented after 10 years of total hip arthroplasty to us with the complains of pain and stiffness in right hip for the past 7 months. Xray pelvis showed protrusion with loosening of acetabular cup and migration of hip center superiorly. She had Paprosky type IIIB acetabular defect with aseptic loosening of cup and a stable femoral component. Revision hip arthroplasty was done with morcellised allograft to bridge the floor of acetabulum and an antiprotrusio reconstruction cage fixed to ilium and ischium with cancellous screws. The acetabular cup was cemented and fixed to cage. Acetabular reconstruction with the use of antiprotrusio cage and allografts can be considered as a reliable procedure to manage severe acetabular defects, enabling restoration of vital bone stock and providing highly successful long-term outcomes after revision arthroplasty.