We report our experience of revision surgery for 4 socket failure after AML type cementless total hip replacement.
Case 1; A right THR was performed in March 1990, in a 61-year-old woman suffered from avascular necrosis. The prosthesis was dislocated 3 times post-operatively and it was replaced under general anesthesia. After the 3rd dislocation, the inner head migrated lateral-superiority and metallosis was suspected. Revision of the socket was performed. Intra-operatively, we recognized polyethylene wear and failure but no metallosis findings were found, so we revised the inner head and the polyethylene liner.
Case 2; A left (March, 1990) THR and a right THR (with bone graft) (April, 1990) were performed in a 55-year-old woman for rapidly destructive coxopathy. 1 year and 5 months after the operation, the grafted bone was collapsed and the socket was migrated lateral-superiority at the right side. We recognized contact of the metal back with the inner head in X-P in May, 1995 so we performed socket revision in June. Intra-operatively, we recognized severe metallosis and wear of polyethylene and the metal back was replaced with cement, inner head and polyethylene liner.
Trauma and grafted bone collapse are suspected as the cause on the above 2 examples, but a weak point in the construction of the polyethylene liner of AML type total hip replacement must be also taken under consideration.
