Intrapelvic migrations of loosened total hip arthroplasties are rare. Primary objective of revision arthroplasty in these cases is the reconstruction of acetabular defects for example by acetabular reinforcement rings. Presenting 3 cases the possibilities and long-term results of Girdlestone situations or arthrodesis of the hip following intrapelvic migration of a total hip arthroplasty are described.
A Girdlestone procedure was performed in a 62-year-old female patient due to intrapelvic migration of a threaded cup and development of a false aneurysm of the iliac artery. 15 years later the patient was out of any complaints. In another patient an arthrodesis of the hip due to destruction of the acetabulum and central migration of a hemiprosthesis was performed. 15 years later, too, this patient was out of any complaints. In a third patient with a contralateral preexisting Girdlestone hip an arthrodesis of the hip due to excessive loosening and severe acetabular defects of a cemented total hip arthroplasty was performed on the other side. 13 years later both hips were stiff, nevertheless the patient was satisfied.
Presenting these cases we come to the conclusion that even now a Girdlestone operation or an arthrodesis of the hip should be taken into account if reconstruction of acetabular defects is no more feasible. The long-term results are satisfactory.