The LINK BiMobile Dual Mobility System implant in Kenya stabilizes a dislocated hip

Case Report: directLINK 2/2020
 

A 71-year-old patient with a stiffened right hip joint suffered from recurrent luxations after the joint was converted to a total hip replacement (TEP). After the last dislocation, he presented himself at St. Luke's Orthopedic and Trauma Hospital in Eldoret, Kenya.

The patient's hip had already stiffened in his childhood for unknown reasons. It was not until the age of 71 that increasing pain in the right hip, right knee joint and lumbar spine led to the surgical conversion of the hip arthrodesis into a hip prosthesis in a local hospital. A cementless total hip prosthesis replaced the hip arthrodesis in August 2019. Postoperatively, a standard prosthesis did not prove successful because the unstable hip repeatedly led to femoral head luxations and the patient's ultimate presentation at St. Luke's Orthopedics and Trauma Hospital.

Due to the previous hip luxation, we decided on an ORIF. Intrasurgical, we found that the hip joint was unstable due to excessive former bone resection and a lack of muscle attachment in the proximal femur. Sufficient hip joint stability could not be achieved despite changing to a larger femoral head and an increased neck length, so further hip joint dislocations occurred postoperatively. Therefore, the only remaining option was to use a LINK BiMobile acetabular cup to achieve sufficient stability in the hip joint. In December 2019, we implanted a BiMobile acetabular cup – the first of its kind in Kenya. A stability enhancing transfer of gluteal muscle was planned initially, but this proved impossible due to atrophy in the musculus gluteus maximus.

Two months postoperation, the hip remains stable. The patient is mobile with a walking aid and is very happy with the surgery outcome. He continues to receive physiotherapy.