Dual total hip joint replacement acetabular cups

Case contributed by Craig Hacking
Diagnosis certain

Presentation

Routine follow up.

Patient Data

Age: 55 years
Gender: Female

There has been revision left total hip arthroplasty. Appearances are similar to prior radiograph from last year. The engaged cup is rotated laterally and the medial screw protrudes into the pelvis.

There is an impacted second acetabular cup with associated mesh superior to the hip joint replacement, also with similar appearance.

No fracture identified.

Case Discussion

Revision THR femoral stems are usually long and require cerclage wires for internal fixation, as the femoral shaft requires surgical fracture to extract the primary THR stem.

Why cup on a cup? The primary THR acetabular cup and mesh could not be extracted during the revision and it's subsidence superiorly deemed it unsuitable to use with the revision femoral head.

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