Total Hip Arthroplasty for Post-Traumatic Hip Arthritis in Chronic Pubic Diastasis: A Case Report.

Abstract

Introduction: Total hip arthroplasty (THA) in the presence of chronic pubic diastasis is uncommon and technically demanding due to hemipelvic malrotation and abnormal acetabular orientation.

Case presentation: A 41-year-old woman developed advanced post-traumatic hip osteoarthritis following fixation of an acetabular fracture and sacroiliac joint injury, complicated by a 90-mm chronic pubic diastasis. Preoperative imaging showed a vertically oriented, retroverted acetabulum with external hemipelvic rotation. THA was performed using a modified posterolateral approach with normalized imaging and landmark-based acetabular orientation. A press-fit uncemented acetabular component with a dual-mobility liner and a short uncemented femoral stem were implanted. The postoperative course was uneventful. The Harris Hip Score improved from 74 at 2 weeks to 93 at 12 weeks, and radiographs up to 2 years confirmed stable osseointegration.

Conclusion: This case highlights technical strategies for performing THA in post-traumatic pubic diastasis with prior fixation, emphasizing functional pelvic normalization and reproducible landmark-based acetabular orientation. This report was prepared in accordance with CARE guidelines.