Acetabular prosthetic protrusion and sepsis: case report and review of the literature.

Acetabular prosthetic protrusio is an unusual complication of total hip arthroplasty that develops from erosion of the medial acetabular wall and intrapelvic migration of the implant. This report reviews 3 cases of severe intrapelvic prosthetic migration where acute or chronic sepsis was associated with the condition. All subjects were female and involved the left hip. In each case, debridement of the intrapelvic implant was required with an intra-abdominal approach. After successful eradication of infection, 2 patients have a well-functioning reimplanted prosthesis, and 1 was left with a Girdlestone arthroplasty. Literature review revealed that 11 of 16 similar prosthetic protrusion cases had chronic sepsis, of which, 10 were female and 9 involved the left hip. Chronic infection should be considered when intrapelvic prosthetic migration occurs after total hip arthroplasty.