72-year-old female patient
Revision, Treatment with MobileLink and Face Changer
Dr. Steffen Brodt
Head of Department Hip
Waldklinken Eisenberg
Germany
Case Description
Preoperative X-ray, February 2021
- 2000: Primary implantation THA re. ex domo
- 10/2018: THA replacement r. ex dom
- 11/2019: Presented at the consultation with persistent discomfort in right leg/hip joint.
- X-ray/scinti:
- Stem loosening of the inserted long revision stem with significant, elongated destruction of the lateral cortex (Paprosky IIIB).
- Puncture with no evidence of bacteria (aseptic)
Course of Treatment
Postoperative X-ray, 12-week follow-up
Postoperative X-ray (lateral), May 2021
- 03/2021: complete THA removal, debridement, lavage, creation of Girdlestone situation with spacer (two-stage procedure)
- Defect classification acetabulum: Paprosky IIB
- 05/2021: Reimplantation THA right with allogeneic spongiosaplasty for defect filling cranially
- Dorsally, the posterior acetabular wall was destroyed by the screw-in cup
- As a result, the primary stability of the cup was affected and implantation was performed with approx. 10-15° retroversion to allow a press-fit at all
- To achieve an anteversion, the 20° Face Changer was implanted, resulting in an antetorsion of approx. 5-10°
- Mobilization was initially performed with a partial load of 20 kg, and after 6 weeks the load was gradually increased to full load
- Components of the MobileLink Acetabular Cup System:
- MobileLink TiCaP Cluster Hole, size 62
- Face Changer: Offset 8mm and Inclination 20°
- Insert PE / size E
- Bone Screws 6.5 / 20mm; 6.5 / 35mm
Conclusion
Postoperative X-ray (lateral), 12-week follow-up
X-ray of the spacer, March 2021
- The modular MobileLink Acetabular Cup System allowed a secure and luxation-stable positioning of the acetabular cup. Due to the absence of a posterior acetabular rim, implantation of the primary cup in slight retroversion was necessary to ensure the stable anchorage of the cup. Thanks to the Face Changer - it was possible to adjust the inclination and anteversion within the anticipated "safe zone" based on Lewinnek without any problems.
- The result was a pain-free patient with a safe mobilization
- X-ray after 12 weeks:
- Secure acetabular cup without secondary dislocation with clinically stable joint conditions
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