RESEARCH ARTICLE


Intrapelvic Dislocation of a Femoral Trial Head During Primary Total Hip Arthroplasty Requiring Laparotomy for Retrieval



Mustafa Citak*, 1, Till Orla Klatte 1, Akos Zahar 1, Kimberly Day 1, Daniel Kendoff 1, Thorsten Gehrke 1, Arnulf Dörner 2, Matthias Gebauer 1
1 Helios Endo-Klinik Hamburg, Department of Orthopaedic Surgery, Hamburg, Germany
2 Agaplesion Diakonieklinikum Hamburg, Department of Abdominal Surgery, Hamburg, Germany


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© Citak et al.; Licensee Bentham Open.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.5/) which permits unrestrictive use, distribution, and reproduction in any medium, provided the original work is properly cited.

* Address correspondence to this author at the Department of Orthopaedic Surgery, Helios Endo Klinik Hamburg, Holstenstrasse 2, D-22767 Hamburg, Germany; Tel: +49 40 3197 1649; Fax: + 49 40 3197 0; E-mail: mcitak@gmx.de


Abstract

Background and Purpose:

Total hip arthroplasty (THA) is a safe and reliable surgical procedure. However, THA also has intra- and postoperative complications. A dreaded and frustrating intraoperative complication during total hip arthroplasty is dislocation of the femoral trial head from the neck into the pelvis.

Methods:

Here, we report on the case of a 71-year old female patient with osteoarthritis of the left hip. Total hip arthroplasty was performed in a lateral position through a standard posterior approach. During intraoperative trial reduction, the femoral trial head dissociated from the taper and dislocated into the psoas compartment. Several unsuccessful attempts, including an additional ventral approach, were made to immediately retrieve the femoral trial head.

Results and interpretation:

Postoperative a Computerized Tomography (CT) was performed to locate the trial head, a secondary explorative laparotomy was undertaken to retrieve it. The retrieval of the femoral trial head should be performed in a planned second surgical procedure to avoid possible complications during the manipulation necessary for retrieval.

Keywords: Complication, femoral trial head, laparotomy, retrieval, total hip arthroplasty, total hip replacement.