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Case Reports
. 2025 Mar 28;2025(4):rjaf091.
doi: 10.1093/jscr/rjaf091. eCollection 2025 Apr.

The para-rectus approach for extraction of intra-pelvic migrated acetabular implants

Mohamed Amine Selmene  1   2 , Youssef Jaballah  1   2 , Sabri Mahjoub  1   2 , Hedi Annabi  1   2 , Mourad Zaraa  1   2
Affiliations
Case Reports

The para-rectus approach for extraction of intra-pelvic migrated acetabular implants

Mohamed Amine Selmene et al. J Surg Case Rep. .

Abstract

Primary and revision total hip arthroplasty can be complicated by intrapelvic migration of the acetabular components. This complication constitutes an evolutionary turning point in the history of this prosthesis since it could lead to compression or invasion of noble intra-pelvic structures. The second problem lies in the extraction of these implants in this anatomically dangerous region. We report the case of a patient who was operated on for a septic loosening of her total hip arthroplasty with protrusion of the acetabular components (Kerboull cross-plate and the cup) intrapelvicly via the para-rectus approach which allowed safe removal of these implants. This is an intra-pelvis approach lateral to the rectus abdominis muscle, initially described in acetabular fractures, with few studies reporting its use in this type of complex situations.

Keywords: acetabular components; hip; intra-pelvic migration; para-rectus approach.

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Conflict of interest statement

We declare that we have no conflict of interest.

Figures

Figure 1
Figure 1
A- revision of the left total hip arthroplasty: postoperative pelvis X-ray. B- pelvis X-ray: Intrapelvic migration of acetabular components (Kerboul cross-plate and the cup).
Figure 2
Figure 2
A- drawing of the scar of the para-rectus approach. Bony landmarks: right arrow: anterior superior iliac spine, up left arrow: umbilicus, bottom left arrow: pubic symphysis. B- scar size. C- intraoperative view of the acetabular implant before their extraction. The left arrow corresponds to the medial part where there are the lateral iliac vessels protected. The right arrow corresponds to the lateral part with the iliopsoas muscle spread apart. D- acetabular implants removed.
See this image and copyright information in PMC

References

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