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Case ReportCase Reports and Clinical Observations

Total Hip Arthroplasty Dislocations Are More Complex Than They Appear: A Case Report of Intraprosthetic Dislocation of an Anatomic Dual-Mobility Implant After Closed Reduction

Bradford S. Waddell, Ivan De Martino, Thomas Sculco and Peter Sculco
Ochsner Journal June 2016, 16 (2) 185-190;
Bradford S. Waddell
Department of Adult Reconstruction and Joint Replacement, Hospital for Special Surgery, New York, NY
MD
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Ivan De Martino
Department of Adult Reconstruction and Joint Replacement, Hospital for Special Surgery, New York, NY
MD
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Thomas Sculco
Department of Adult Reconstruction and Joint Replacement, Hospital for Special Surgery, New York, NY
MD
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Peter Sculco
Department of Adult Reconstruction and Joint Replacement, Hospital for Special Surgery, New York, NY
MD
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Article Figures & Data

Figures

  • Figure 1.
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    Figure 1.

    In the typical dual-mobility construct, a small central metal or ceramic head couples with a large polyethylene head inside the acetabular cup.

  • Figure 2.
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    Figure 2.

    X-ray shows the dislocated and uncoupled polyethylene head in the soft tissue. The arrows surround the bubble sign of the polyethylene head apparent in the soft tissue.

  • Figure 3.
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    Figure 3.

    Our patient's initial x-ray after dislocation. The properly coupled large polyethylene head can be seen as a shadow around the small femoral head.

  • Figure 4.
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    Figure 4.

    Our patient's x-ray after the reduction attempt. The small femoral head is eccentric inside the acetabular cup. The arrows show the dissociated polyethylene femoral head in the soft tissue.

  • Figure 5.
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    Figure 5.

    A: Coronal computed tomography (CT) image shows the polyethylene head dissociated and in the soft tissue. The arrows surround the polyethylene head. B: In a similar CT image in the axial plane, the arrows show the polyethylene head.

  • Figure 6.
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    Figure 6.

    A: Intraoperative photograph of our patient. After slight dissection down, the polyethylene head was visualized and photographed. B: Our patient's dissociated dual-mobility prosthesis in the operating room after removal.

  • Figure 7.
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    Figure 7.

    Postoperative x-ray shows the concentric reduction and proper alignment after revision dual-mobility implant.

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Vol. 16, Issue 2
Jun 2016
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Total Hip Arthroplasty Dislocations Are More Complex Than They Appear: A Case Report of Intraprosthetic Dislocation of an Anatomic Dual-Mobility Implant After Closed Reduction
Bradford S. Waddell, Ivan De Martino, Thomas Sculco, Peter Sculco
Ochsner Journal Jun 2016, 16 (2) 185-190;

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Total Hip Arthroplasty Dislocations Are More Complex Than They Appear: A Case Report of Intraprosthetic Dislocation of an Anatomic Dual-Mobility Implant After Closed Reduction
Bradford S. Waddell, Ivan De Martino, Thomas Sculco, Peter Sculco
Ochsner Journal Jun 2016, 16 (2) 185-190;
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Cited By...

  • Dual mobility hip arthroplasty: iatrogenic intraprosthetic dislocation of a 22 mm head
  • Dislocation of the Hip: A Review of Types, Causes, and Treatment
  • Dual mobility total hip dislocation--femoral stem loosening while attempting closed reduction: a cautionary note
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Keywords

  • Arthroplasty–replacement–hip
  • hip dislocation
  • hip prosthesis

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