Total Hip Arthroplasty with Cage Application for Complex Posterior Hip Dislocation and Acetabular Fracture in a Patient with Prior Patellectomy: A Case Report.

Abstract

Introduction: Neglected complex posterior hip dislocations with associated acetabular fractures are rare but challenging injuries. When compounded by biomechanical alterations such as a prior patellectomy, surgical planning becomes more complicated. Total hip arthroplasty (THA) with acetabular cage reconstruction is a viable salvage option to restore hip stability and function in such scenarios.

Case report: We report a case of a 42-year-old male with a chronic posterior dislocation of the right hip and a comminuted posterior wall and column acetabular fracture, presenting 2 months post-injury. The patient had previously undergone a right-sided patellectomy. Surgical intervention included THA with acetabular cage reconstruction due to segmental bone loss. At 6-month follow-up, the patient achieved pain-free ambulation, a stable prosthesis, and satisfactory functional outcomes.

Conclusion: This case highlights the successful use of acetabular cage-assisted THA in a patient with both complex hip trauma and altered knee biomechanics. Early intervention, comprehensive surgical planning, and the use of modern implants are key in managing such rare and challenging presentations.