Revision Total Hip Arthroplasty for Recurrent Dislocation in a Young Adult: A Case Report
Abstract:
Introduction: Total hip arthroplasty (THA) is the treatment of choice for advanced hip osteoarthritis, including cases secondary to developmental disorders. Despite generally favourable outcomes, recurrent prosthetic dislocation remains a challenging complication, particularly in young and physically active adults. In younger patients, implant selection options are limited and long-term durability is a major concern, rendering future revision surgeries more complex.
Case Presentation: A 34-year-old woman who had undergone right THA for osteoarthritis secondary to slipped capital femoral epiphysis presented with sudden severe pain and functional limitation five years after surgery, without recent trauma. Plain radiography and computed tomography revealed no abnormalities, while bone scintigraphy demonstrated marked periprosthetic metabolic activity surrounding the femoral stem of the right hip prosthesis (Figure 1). Laboratory markers showed no evidence of infection.
Therapeutic Intervention and Outcome: After excluding prosthetic joint infection, revision surgery was performed with replacement of the femoral head by a larger-diameter component to enhance joint stability. Intraoperative cultures and histological examination were negative. The patient underwent a structured rehabilitation programme, progressively recovered function, and returned to work after three months.
Discussion and Clinical Relevance: This case highlights the limitations of static imaging modalities in the assessment of dynamic instability and underscores the importance of individualized clinical evaluation, careful implant selection, and efficient resource management. Delay in surgical intervention resulted in occupational and indirect economic impact.
Conclusion: Targeted revision surgery, structured rehabilitation, and rational use of healthcare resources may lead to favourable functional outcomes. Case reports remain essential for sharing clinical experience in complex scenarios.
