Case Report: Painless Chronic Liner Dissociation of a Total Hip Arthroplasty

Abstract

Background Dislocation or liner dissociation of a total hip prosthesis usually results in pain and discomfort. Although several reports describe chronic dislocation and its treatment, chronic liner dissociation is an unreported complication. Case Description We report an unrecognized dissociation and displacement of the liner of a total hip prosthesis after revision THA. The patient had virtually no pain or functional restrictions. The patient's only complaint was pain on the contralateral side, associated with a leg-length discrepancy. Since the patient had no complaints relative to the liner dissociation we elected not to pursue further treatment. The contralateral pain was treated successfully with a shoe lift. Literature Review Chronic dislocation of a THA is a rare complication and we found reports of only seven cases in the literature. We found no reports of chronic liner dissociation. Clinical Relevance Orthopaedic surgeons should be aware of the possibility of this rare complication. Our case and the literature suggest treatment can be nonsurgical or surgical.

Chiropractic Management of Low Back Pain in a 75-Year-Old Man With Bilateral Developmental Hip Dysplasia

“…Consistent with this notion are 2 reported cases of elderly patients who had suffered chronic dislocation of a surgically replaced femoral head without suffering pain from any bony or soft tissue structure on the side ipsilateral to the dislocation. 16,17 This case indicates that, unlike acquired hip joint dysfunction, developmental abnormalities of the hip joints (even when severe), leading to substantial biomechanical alterations in posture and gait, may not cause pain almost throughout life. It also indicates that a severe change in biomechanics of the spine as a result of the absence of hip joints produces a very different pattern of osteoarthritic change in the lumbar spine likely as a result of the alteration in the pattern of joint loading.…”

Catastrophic failure of an acetabular total hip arthroplasty component mimicking a posterior dislocation

“…A comprehensive review of the literature was performed, and 7 reports of chronic hip prosthetic dislocations were discovered [6], [7], [8], [9], [10], [11], [12]. In 2 cases, the patients had no associated pain and were treated without intervention [8], [11]. One patient underwent successful open reduction with soft tissue closure [12], and another with a revision total hip replacement [9].…”

Dissociation of Polyethylene Liner of the Dual Mobility Acetabular Component after Closed Reduction of Dislocation: A Case Report

“…The component can reduce the wear of a liner, prevalence of dislocation and liner dissociation 1 2 4) . The implants reduce the wear with dual articulation by offering the PE liner mobility in the acetabular cup 2 5 6 7) . In addition, it increases jump distance and postoperative stability by having the same effect as using a large femoral head 7) .…”