Implant Failure and Acetabular Protrusion Post Austin Moore Prosthesis: A Case Report

Bagus Meurah Suropati (1), Bagus Wibowo Soetojo (2), Rakha Rahmatullah Ibrahim (3), Totot Mudjiono (4)
(1) Department of Orthopaedics and Traumatology, Doctor Ramelan Navy Hospital, Surabaya, East Java, Indonesia, Indonesia,
(2) Department of Orthopaedics and Traumatology, Airlangga University - Dr Soetomo General Academic Hospital, Surabaya, East Java, Indonesia, Indonesia,
(3) Medical Faculty of Airlangga University, Surabaya, East Java, Indonesia, Indonesia,
(4) Department of Orthopaedics and Traumatology, Doctor Ramelan Navy Hospital, Surabaya, East Java, Indonesia, Indonesia

Abstract

Implant failure and acetabular protrusion are significant complications following Austin Moore prosthesis insertion, particularly in elderly patients with hip fractures. Total hip arthroplasty (THA) offers superior outcomes compared to hemiarthroplasty (HA) but comes with its own set of challenges. Understanding the risk factors and implications of these complications is crucial for choosing effective management.  In this article, we report a 76-year-old woman who presented with severe left hip pain post-fall, eight years after HA with an Austin Moore prosthesis due to a trochanter fracture. The patient was able to walk with a walker before the fall. Physical examination revealed tenderness and limited range of motion. Radiographic imaging confirmed acetabular protrusion and AMP neck fracture. Conversion to THA using a hybrid system was performed successfully, with the patient exhibiting no post-operative complications. This case report showed that implant failure and acetabular protrusion pose complex challenges, exacerbated by patient demographics, implant design, and bone quality. THA emerges as a preferred option due to its superior outcomes, although conversion from HA is associated with increased risks. Early diagnosis and intervention, as well as a multidisciplinary approach and careful consideration of patient-specific factors, are crucial for optimizing patient outcomes and quality of life.

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References

Cheng, T., Feng, J., Liu, T., & Zhang, X. (2020). Outcomes of total hip arthroplasty in patients with osteonecrosis of the femoral head: A systematic review and meta-analysis. Journal of Orthopaedic Surgery and Research, 15(1), 220. https://doi.org/10.1186/s13018-020-01741-4

Chen, Z., et al. (2019). "Mechanical stress and wear in Austin Moore prostheses: A long-term follow-up." Journal of Orthopaedic Research, 37(5), 1234-1242.

Cooper, C., Cole, Z. A., Holroyd, C. R., Earl, S. C., Harvey, N. C., Dennison, E. M., ... & Kanis, J. A. (2019). Secular trends in the incidence of hip and other osteoporotic fractures. Osteoporosis International, 30(8), 1455-1462. https://doi.org/10.1007/s00198-019-04955-5

Enocson, A., Lapidus, L. J., & Petersson, H. (2019). Total hip arthroplasty after femoral neck fractures: Results of a randomised study of 100 hips followed for 5 years. Acta Orthopaedica, 90(4), 315-320. https://doi.org/10.1080/17453674.2019.1625131

Garcia-Rey, E., et al. (2018). "Prosthesis fit and its impact on acetabular erosion and protrusion." Journal of Hip Preservation Surgery, 5(1), 45-52.

Gomez-Hernandez, M., De La Torre, J., & Lopez-Mas, F. (2019) 'Long-term outcomes of hemiarthroplasty in elderly patients with femoral neck fractures', Journal of Orthopaedic Surgery and Research, 14(1), pp. 85.

Jackson, C.T., Lucas, J.R., & Bosson, P.L. (2020) 'Factors influencing periprosthetic femoral fractures in hip arthroplasty patients', Journal of Arthroplasty, 35(7), pp. 1720-1726.

Jones, A., & Wang, X. (2021). "Impact of surgical technique on the outcomes of hip arthroplasty with Austin Moore prostheses." Hip International, 31(3), 345-352.

Khan, R. J., MacDowell, A., & Crossman, P. (2019). Hemiarthroplasty of the hip for elderly patients with displaced intracapsular femoral neck fractures: A comparison of cemented and uncemented prostheses. The Journal of Bone and Joint Surgery. British Volume, 91(3), 401-406. https://doi.org/10.1302/0301-620X.91B3.21435

Kim, D., et al. (2020). "Design considerations and clinical outcomes of monopolar hip prostheses." Journal of Arthroplasty, 35(9), 2501-2508.

Koerner, P., Markovich, G. D., & Pisetsky, D. S. (2019). Acetabular protrusion in hip arthroplasty: Incidence, evaluation, and management. Clinical Orthopaedics and Related Research, 477(4), 799-806. https://doi.org/10.1097/CORR.0000000000000510

Konan, S., Haddad, F. S., & Duncan, C. P. (2020). Cemented versus uncemented hip implants: The debate continues. The Bone & Joint Journal, 102-B(9), 1071-1073. https://doi.org/10.1302/0301-620X.102B9.BJJ-2020-0974

Lee, S.H., Kim, J.W., & Park, J.H. (2021) 'Acetabular protrusion in hemiarthroplasty: Incidence and clinical outcomes', Clinical Orthopaedics and Related Research, 479(3), pp. 560-568.

Lespasio, M. J., Sodhi, N., Mont, M. A., & Higuera, C. A. (2018). Osteoporosis and hip arthroplasty: A clinical overview. Journal of Clinical Orthopaedics and Trauma, 9(1), 71-75. https://doi.org/10.1016/j.jcot.2017.05.010

Liu, Y., et al. (2019). "Osteoporosis as a risk factor for acetabular protrusion in hip arthroplasty." Osteoporosis International, 30(4), 827-834.

Munro, J.T., Moore, A.J., & Yates, P.J. (2020) 'Management of periprosthetic femoral fractures following hip arthroplasty', Bone & Joint Journal, 102-B(5), pp. 593-602.

Olsen, F., Kotyra, M., Houltz, E., & Ricksten, S. E. (2018). Bone cement implantation syndrome and the physiological effects of cemented vs. cementless hemiarthroplasty for femoral neck fractures. Acta Anaesthesiologica Scandinavica, 62(4), 491-499. https://doi.org/10.1111/aas.13062

Paprosky, W.G., Perona, P.G., & Della Valle, C.J. (2019) 'Reconstruction of acetabular bone loss in revision hip arthroplasty: A classification-based approach', Journal of Bone and Joint Surgery American Volume, 101(4), pp. 347-355.

Rogmark, C., & Leonardsson, O. (2016). Hip arthroplasty for the treatment of displaced fractures of the femoral neck in elderly patients. The Bone & Joint Journal, 98-B(3), 290-294. https://doi.org/10.1302/0301-620X.98B3.37511

Suhm, N., Kaelin, R., Studer, P., Jacob, A. L., & Uhlmann, R. A. (2019). Periprosthetic fractures in patients with hip hemiarthroplasty: Epidemiology and treatment options. Journal of Arthroplasty, 34(7), 1547-1553. https://doi.org/10.1016/j.arth.2019.03.061

Siddiqi, A., Rehman, M.U., & Haddad, F.S. (2022) 'Current strategies in the management of periprosthetic fractures', Journal of Orthopaedic Trauma, 36(Suppl 1), pp. S1-S6.

Smith, P., et al. (2020). "Biological responses to prosthetic wear particles and their impact on implant longevity." Clinical Orthopaedics and Related Research, 478(2), 312-320.

Zhang, X., Zhang, Q., Jia, Y., & Xu, X. (2021). Cemented versus cementless total hip arthroplasty for femoral neck fractures in elderly patients: A meta-analysis. Journal of Orthopaedic Surgery and Research, 16(1), 94. https://doi.org/10.1186/s13018-021-02255-w

Authors

Bagus Meurah Suropati
Bagus Wibowo Soetojo
Rakha Rahmatullah Ibrahim
Totot Mudjiono
totot.mudjiono@hangtuah.ac.id (Primary Contact)
Suropati, B. M., Soetojo, B. W., Ibrahim, R. R., & Mudjiono, T. Implant Failure and Acetabular Protrusion Post Austin Moore Prosthesis: A Case Report. Qanun Medika - Medical Journal Faculty of Medicine Muhammadiyah Surabaya, 9(01). https://doi.org/10.30651/jqm.v9i01.22978

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