Summary from a publication in BMJ JOURNALS by Ms. Drakou and her colleagues.
The case concerns a 51-year-old man with no prior history, who suffered bilateral central hip dislocations after a sudden episode of epileptic seizures. He was initially managed conservatively for 9 months, but developed severe functional disability due to hip stiffness and left peroneal nerve palsy.
Treatment included:
- Bilateral total hip arthroplasty using a minimally invasive anterior approach
- Use of a tripolar head mechanism
- Cementing of the prostheses into a biologic acetabular support constructed from autologous bone graft
- Use of the femoral heads and necks as “plugs,” placed within the acetabular defects, applying tension to the medial acetabular walls
Results
- At 24 months postoperatively, the patient showed good functional recovery.
- Reconstruction and regeneration of the medial acetabular walls was observed on both sides
Conclusion
In cases of traumatic acetabular protrusion, biological and functional reconstruction of the acetabular wall can be achieved using tension-stress principles and minimally invasive techniques.
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