Pita Sérgio, Pato Tiago, Dos Santos André Ferreira
Department of Orthopaedics and Traumatology, Centro Hospitalar do Baixo Vouga - Aveiro, Portugal.
Department of Orthopaedic Surgery, Hospital da Prelada - Porto, Portugal.
J Orthop Case Rep. 2022 Sep;12(9):78-83. doi: 10.13107/jocr.2022.v12.i09.3326.
Intrapelvic migration of the femoral head is a rare complication of total hip arthroplasty (THA).
A 54-year-old Caucasian female was submitted to revision THA. She suffered an anterior dislocation and avulsion of the prosthetic femoral head that required open reduction. Intraoperatively, the femoral head migrated into the pelvis, along the psoas aponeurosis. The migrated component was retrieved on a subsequent procedure, through an anterior approach to the iliac wing. The patient had a good post-operative course and 2 years after surgery she has no complains related to this complication.
Most of the cases described in the literature are of intraoperative migration of trial components. The authors found only one case described involving a definitive prosthetic head, but during primary THA. No case was found due to post-operative dislocation or definitive femoral head migration after revision surgery. Due to the lack of long-term studies of intra pelvic implant retention, we recommend to remove these implants, particularly in younger patients.
股骨头向盆腔内移位是全髋关节置换术（THA）一种罕见的并发症。
一名54岁的白种女性接受了THA翻修手术。她发生了人工股骨头前脱位和撕脱，需要切开复位。术中，股骨头沿着腰大肌腱膜移入盆腔。在随后的手术中，通过髂骨翼前路取出了移位的部件。患者术后恢复良好，术后2年她没有关于该并发症的任何主诉。
文献中描述的大多数病例是试验部件术中移位。作者仅发现1例涉及初次THA时确定性假体股骨头移位的病例。未发现翻修手术后因术后脱位或确定性股骨头移位的病例。由于缺乏关于盆腔内植入物留存的长期研究，我们建议取出这些植入物，尤其是在年轻患者中。
