Selmene Mohamed Amine, Jaballah Youssef, Mahjoub Sabri, Annabi Hedi, Zaraa Mourad
Orthopaedic Department, Trauma and Burns Center, May 1st Street, 2013, Ben Arous, Tunisia.
Faculty of Medicine of Tunis, University Tunis El Manar, 15, Djebel Lakhdhar Street, Bab Saadoun, 1007, Tunis, Tunisia.
J Surg Case Rep. 2025 Mar 28;2025(4):rjaf091. doi: 10.1093/jscr/rjaf091. eCollection 2025 Apr.
Primary and revision total hip arthroplasty can be complicated by intrapelvic migration of the acetabular components. This complication constitutes an evolutionary turning point in the history of this prosthesis since it could lead to compression or invasion of noble intra-pelvic structures. The second problem lies in the extraction of these implants in this anatomically dangerous region. We report the case of a patient who was operated on for a septic loosening of her total hip arthroplasty with protrusion of the acetabular components (Kerboull cross-plate and the cup) intrapelvicly via the para-rectus approach which allowed safe removal of these implants. This is an intra-pelvis approach lateral to the rectus abdominis muscle, initially described in acetabular fractures, with few studies reporting its use in this type of complex situations.
初次和翻修全髋关节置换术可能会因髋臼组件向盆腔内移位而变得复杂。这种并发症是该假体历史上的一个演变转折点,因为它可能导致盆腔内重要结构受到压迫或侵犯。第二个问题在于在这个解剖结构危险的区域取出这些植入物。我们报告了一例患者,她因全髋关节置换术后感染性松动接受手术,髋臼组件(Kerboull交叉钢板和髋臼杯)经腹直肌旁入路向盆腔内突出,该入路使得这些植入物得以安全取出。这是一种在腹直肌外侧的盆腔内入路,最初用于髋臼骨折,很少有研究报道其在这类复杂情况下的应用。