Early loosening and secondary dislocation due to a broken trochanteric osteotomy wire following a Charnley total hip arthroplasty: a case report
© licensee BioMed Central Ltd. 2009
Received: 7 April 2009
Accepted: 30 April 2009
Published: 29 May 2009
We report a case of interposition of a broken trochanteric wire in the hip joint. This caused early wear of the prosthesis and dislocation of the Charnley total hip arthroplasty. The patient was treated with a revision total hip arthroplasty. This rare complication should be taken into consideration when performing a trochanteric osteotomy fixation with wiring in Charnley total hip arthroplasty.
Trochanteric osteotomy is a known method used in Charnley total hip arthroplasty. The advantage of the transtrochanteric approach is that it gives a better view of the hip joint. The disadvantages of this method are increased operative time, increased blood loss, trochanteric non union and trochanteric bursitis [1, 2]. We report a rare complication associated with trochanteric osteotomy.
Articular interposition of a broken wire in the hip joint is a rare complication following Charnley total hip arthroplasty. Four cases have been reported in the literature. The first case was a 53 year old male who had a revision arthroplasty because of a worn acetabular cup due to an intra-articular wire fragments found two years after Charnley total hip arthroplasty .
The second case was a 64 year old male who was found to have a wire on the X-rays after three years of the operation. He did not have any symptoms but after 12 years required revision arthroplasty due to cup wear .
The third case was an 80 year old female who experienced multiple dislocations of the hip 10 years following Charnley total hip arthroplasty. The wires were taken out arthroscopically .
The fourth case was an 80 year old female who had recurrent dislocations 10 years after the operation. Plain X-rays showed intra-articular wires. She required a revision arthroplasty due to prosthetic components wear .
In our case, the patient did not have any problems post operatively for three years until he experienced his first dislocation.
The interposition of broken trochanteric wires in the hip joint post Charnley total hip arthroplasty can cause a third body effect leading to early loosening and early wear of the prosthetic components leading to dislocation of the hip. It is a complication that should be considered when performing a Charnley total hip arthroplasty which might necessitate an early revision surgery.
The patient agreed for this case report to be published after obtaining informed consent. However, the form at that time was not available to be signed.
- Wroblewski B: Revision Surgery in Total Hip Arthroplasty. 1990, Springer- Verlag, 19-28. 1View ArticleGoogle Scholar
- Charnley J, Ferreira A: Transplantation of the greater trochanter in arthroplasty of the hip. J Bone Joint Surg. 1994, 46B: 191-197.Google Scholar
- Bronson J: Articular interposition of trochanteric wires in a failed total hip replacement. Clin Orthop. 1986, 121: 50-52.Google Scholar
- Ritter M, Meding J: Intra-articular trochanteric wire migration following bilateral total hip arthroplasty. Orthopaedic. 1998, 11: 1295-1297.Google Scholar
- Lim A, Parekh S, Smith D: Intra-articular migration of broken trochanteric wires. Injury. 1993, 24: 201-202. 10.1016/0020-1383(93)90299-L.View ArticlePubMedGoogle Scholar
- Fakih R, Treacy RBC: Articular Interposition of Broken Trochanteric Wires. Bulletin Hospital for Joint Diseases. 1998, 57: 108-110.Google Scholar
This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.