Injury to the Colon During Revision Total Hip Arthroplasty
A Case Report
Lindsey S. Hagstrom, BA; Dennis J. Callahan, MD; James W. Green, MD

A young woman with rheumatoid arthritis underwent revision of an acetabular component of a total hip prosthesis because of progressive osteolysis about the acetabular screw holes. During curettage of the membrane of one of the screw holes, a portion of the colon adjacent to the acetabulum was grasped and inadvertently injured. To the best of our knowledge, this is the first report of this intra-abdominal complication. We obtained institutional review board approval for this retrospective report. Our patient was informed that data concerning the case would be submitted for publication, and she consented.

Case Report

A twenty-nine-year-old woman with a medical history of rheumatoid arthritis underwent right and left total hip arthroplasties in August and October 1993, respectively. Approximately 8.5 years later, in January 2002, the patient underwent revision arthroplasty of the right hip because of progressive periacetabular osteolysis. Preoperatively, an anteroposterior pelvic radiograph and computed tomographic scan demonstrated that the stems were well fixed. The right acetabular cup was medial to the ilioischial line, and there were osteolytic lesions in the acetabulum adjacent to the screw holes (Figs. 1 and 2). Since the metallic acetabular component appeared to be solidly fixed on these images, the preoperative plan was to remove the polyethylene component only, curette the lytic lesions through the screw holes, pack them with morcellized allograft, and insert a highly cross-linked polyethylene component liner.

Fig. 1

An anteroposterior pelvic radiograph demonstrating osteolysis adjacent to the screw holes of the right acetabular component (upper …

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