PMC9091384_01
(a) Anteroposterior and (b) Cross-table lateral radiographs 5 years after right cemented bipolar hemiarthroplasty, Anteroposterior radiographs demonstrating complete wear-through of the femoral head through the polyethylene liner and outer metal dome of monoblock shell into the weight bearing roof of the acetabulum. The arrows indicates: zone of osteolysis (upper); head is in direct contact with the acetabulum (lower), Cross-table lateral radiographs demonstrating complete wear-through of the femoral head through the polyethylene liner and the bipolar cup into the weight bearing roof of the acetabulum.(toward the acetabulum: red circle delineate the outer metallic dome of monoblock shell; yellow circle delineate the head. Different colors are used to show the breach in outer metallic case). The arrow indicated the avulsed metallic fragment.
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F1
A piece of metal chip can also be seen at the margin of Bipolar Head (Fig. 1a, 1b).
Black metallosis debris (arrow).
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F2
Upon entry into the hip capsule, there was a small amount of dark-colored metallic debris, which was thoroughly debrided and lavaged from the hip (Fig. 2).
Bipolar head dissociated; the whole bipolar assembly; femoral head with monoblock shell; an avulsed fragment of metallic dome.
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F3
The bipolar head was dissociated and removed (Fig. 3).
Spectro-analysis showing the wear of polyethylene and thickness of outer metallic dome.
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F4
The bipolar monobloc shell was sent to our biomechanics laboratory for critical analysis (Fig. 4).
An anteroposterior view of pelvis showing right hip: latest follow-up demonstrating stable implant component.
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F5
During his last follow-up, 5-years post-surgery, Harris Hip score was improved from poor to excellent, radiographs show both components stable, and clinical examination did not reveal any abnormality (Fig. 5).