Intracolonic Migration of a Dislocated Acetabular Cup Prosthesis.

Abstract

Background: Acetabular cup migration is a rare complication of hip replacement surgery. If the acetabular socket of the ilium is weak, the prosthesis can erode or pass through it. There have been multiple reports of acetabular cup prosthesis migration to the colon, creating a coloarticular fistula between the hip joint and the cecum, sigmoid colon, or rectum. We report a rare presentation of a complete intracolonic migration of a prosthetic acetabular cup without creating a fistula.

Case presentation: A 53-year-old female patient with a remote history of a total right hip replacement presented with abdominal pain and rectal bleeding. Computed tomography imaging revealed that the acetabular cup prosthesis was inside the colon. The patient underwent a colonoscopy as well as exploratory abdominal surgery, and the object was retrieved. The patient recovered without complications from the surgery. The acetabular cup migrated into the colon without formation of a residual fistula or any notable complications involving the hip joint despite the loss of the acetabular component.

Conclusion: The mechanism is unknown for how the acetabular prosthesis was able to pass from the hip joint into the colon, without a fistula, bowel perforation, or significant hip injury. At the time of writing, this case appears to be the first to document a complete intracolonic migration of a hip prosthesis.