Catastrophic failure of total hip arthroplasty

Abstract

Introduction: Total hip arthroplasty (THA) is an option for almost all pathologies that cause chronic functional difficulty of the joint. Ceramic systems exhibit superior wear charac-teristics compared to traditional metal-polyethylene systems. Both systems have long-term complications such as aseptic loosening, dislocation, and infection. Another less-common complication is the catastrophic failure of the acetabular component, which has been reported in ceramic and metal systems. Case report: We present the case of a 58-year old female patient, with a body mass index of 34, with no significant past medical history, and with a diagnosis of left coxarthrosis. She underwent a primary total arthroplasty of the left hip, with poor shortterm evolution. A revision of the left hip arthroplasty was subsequently performed, where abundant metallosis and infiltration of soft tissues were found. Prosthetic material was removed, surgical cleaning was performed, and a cement spacer was placed; findings included abundant metallosis infiltrated in subcutaneous cell tissue and muscle, in addition to the loss of the acetabular fundus. Lastly, the cement spacer was removed without complications and with a satisfactory evaluation. Conclusions: It is a rare entity without a specific incidence. However, it is important to identify it early and perform an early revision of the arthroplasty.