Revision total hip arthroplasty for instability and recurrent dissociation of the acetabular construct after it’s initial placement at the high hip center: a case report

Introduction: Total hip arthroplasty for osteoarthritis secondary to more severe types of developmental dysplasia is a complex procedure, associated with an increased risk of failure, including instability. Different positions of the center of rotation have been described. Purpose: To demonstrate tactical and technical challenges of revision hip arthroplasty after initial high placement of the acetabular component. Case report: A patient underwent primary hip arthroplsty for dysplasia with a high dislocation, an antiprotrusio cage was placed at the high hip center. Recurrent instability was encountered, and then two revisions with cementation of a dual mobility cup into a retained well-fixed cage resulted in dissociation of the constuct. Сonclusion: Proximal and lateral placement of the acetabular component may have an advantage of reducing perioperative morbidity, but if it fails, the following revision is associated with additional difficulties.