Femoral Stem Dislocation Caused by Trunnionosis Along with Adverse Local Tissue Reaction: A Case Report and a New Technique of Head to Cone Cementing

Document Type : CASE REPORT

Authors

1 Joint Reconstruction Research Center (JRRC), Tehran University of Medical Sciences, Tehran, Iran

2 Student Research Committee, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

3 Department of Orthopedic Surgery, Kashani University Hospital, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

4 School of Pharmacy, Kermanshah University of Medical Sciences, Kermanshah, Iran

5 Department of Orthopedic Surgery, School of Medicine, Al-Zahra Hospital, Isfahan University of Medical Sciences Isfahan, Iran

Abstract

In total hip replacement (THR), fretting and corrosion at the modular head-neck junction (trunnionosis) may cause
adverse local tissue reaction (ALTR). In this report, we presented a 34 years woman with a history of THR eight years
ago, presenting with acute pain and limping. The radiographic assessment revealed stem-head dislocation for which
a revision hip surgery was planned. Surprisingly, we observed pseudotumor and tissue necrosis resulting from the
body’s reaction to cobalt-chromium alloy. The revision surgery entailed pseudotumor debridement and replacing the
femoral head with a new metal head (size 36, long). Due to the separation of the femoral head on a stem, we fixed
it on a stem using bone cement. The stem (Omnifit®, Stryker®) was well-fixed and retained to avoid fractures and
infection risk. This technique revealed an acceptable outcome without recurrence of ALTR after a one-year follow-up.
Our findings suggest that stem dislocation secondary to trunnionosis might be a long-term complication after THR
with subsequent ALTR.
Level of evidence: V

Keywords

References

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The Archives of Bone and Joint Surgery
Volume 10, Issue 10
October 2022
Pages 911-915

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History

  • Receive Date: 27 October 2021
  • Revise Date: 05 July 2022
  • Accept Date: 19 July 2022
  • First Publish Date: 15 September 2022

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