Intraoperative Dissociation and Migration of the Trial Bipolar Cup in Hip Hemiarthroplasty: A Rare Case

TL;DR

A rare case of trial component migration during hip surgery is reported, highlighting the need for surgeons to be aware of this complication and its management.

Contribution

This paper reports a rare intraoperative complication in hip hemiarthroplasty and provides insights into its management.

Findings

Intraoperative dissociation and migration of trial bipolar cup occurred during cemented hemiarthroplasty.

A new incision was required to successfully recover the migrated trial cup.

The case emphasizes the importance of surgeon awareness and preventive measures for such rare complications.

Abstract

Femoral neck fractures are an ever-increasing pathology, and with the elderly population on the rise, cases of cemented bipolar hemiarthroplasties are also on the rise. This is a rare case of intraoperative dissociation and migration of the trial components of bipolar hemiarthroplasty. Considering the current literature, all junior surgeons should be aware of this possible development during trial reduction. We present the case of an 82-year-old Caucasian woman suffering from a left femoral neck fracture due to a fall. She was treated surgically with a cemented bipolar hemiarthroplasty, but after trial reduction, the trial components dissociated and migrated inside the pelvis. The attempts at recovery through the current approach failed, and a new incision and approach were needed. A small ilioinguinal incision was performed, and the recovery of the trial cup was successful. The patient recovered with no considerable problems. As the reasons for this rare complication are largely unknown, the surgeon should be careful and take measures to prevent this scenario. Moreover, it is wise to weigh the pros and cons of retrieval through other approaches and choose the best course of action for the patient.

Figures