PMC6442451_01
Anteroposterior X-ray of the pelvis showing acetabular component migration medial to Kohler's line with proximal migration of the stem.
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F1
AP X-ray of the pelvis showed loose cup with migration, medial to Kohler's line and proximal migration of the stem (Figure 1).
CT confirmed the intrapelvic protrusion of the cup, osteolytic defects, and the dome screw which is directed posteriorly.
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F2
CT confirmed the intrapelvic protrusion and showed extensive osteolytic defect with suspicion of pelvic discontinuity (Figure 2).
CT angiography showed mild displacement of the vessels with no evidence of arterial aneurysm.
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F3
Intra-operative clinical photo of the pararectus approach showing the intra-pelvic cup before extraction.
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F4
The head was removed first to improve access to cup (Figure 4).
Intra-operative X-ray, the cup liner construct and the femoral head had been removed. Plating of the anterior column was done.
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F5
Then plating of the anterior column was done to fix the suspected pelvic discontinuity (Figure 5).
A-two year Postoperative follow up, B-immediate postoperative.
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F6
Then the acetabulum was reconstructed with the use of floor and rim mesh with impaction grafting followed by stem revision (Figure 6).