Treatment of Recurrent Total Hip Arthroplasty Dislocation Caused by Distorted Proximal Femoral Anatomy Due to a Previously Healed Trochanteric Fracture

Dislocation and instability of primary total hip arthroplasty (THA) is the leading cause for revision surgery, linked with significant financial burden and patient dissatisfaction. It is a multifactorial complication and requires accurate diagnosis and identification of the causative factors, as well as good preoperative planning for revision surgery. Despite all the best efforts, revision can lead to disappointing and frustrating results. We present a complex case of recurrent THA instability that required multiple operations before the identification of the main cause led to a satisfactory outcome. In addition, this is, to our knowledge, the first report of an Aesculap Plasmacup (Aesculap, Tuttlingen, Germany) liner dissociation and the first case where a previously well-united intertrochanteric fracture has been directly linked to recurrent instability. We aim to raise awareness of the complexity of such complications and the need for careful assessment of all the possible causes.