PMC6126067_01
(a-c) Radiographic images illustrating marked discontinuity of the femoral head and neck, as well as shortening of the right hip prosthesis in what was initially thought to be a trunnion fracture.
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Radiographic images of the right hip showed an apparent trunnion fracture with significant asymmetric wear of the polyethylene liner within the acetabular component (Figure 1).
(a) Femoral head showing no gross signs of wear. (b) Metal-stained debris and granulation tissue widespread within the surgical site. (c, d) Significant trunnion wear along the femoral stem of the primary hardware.
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Though the femoral head was intact and showed no gross signs of wear (Figure 2(a)), there was complete dissociation from the femoral stem. There were also significant signs of metallosis with metal-stained debris and granulation tissue (Figure 2(b)), which extended deep to the margins surrounding the acetabular shell. Interestingly, the femoral stem demonstrated significant medial trunnion wear (see Figures 2(c) and 2(d)), though no true trunnion fracture was noted, contrary to the initial preoperative radiographic assessment.
(a) Anterior-posterior radiograph demonstrating stable fixation after revision surgery. (b) Lateral radiograph demonstrating the same postrevision fixation.
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Intraoperative assessment demonstrated a stable final construct (Figures 3(a) and 3(b)).