Hip Replacement in damaged

Hip Replacement in damaged acetabulum – Dr. Anupam Khandelwal (PROTUSIO ACETABULUM)


What Is Protusio Acetabuli (Protruded Acetabulum)?

Let’s start with the basics. The hip joint is like a ball-and-socket mechanism – the ball is the head of your thigh bone (femur) and the socket is a part of your pelvis, called the acetabulum.

In a condition called Protusio Acetabuli, this socket moves inward – deeper into the pelvis than it should be. This makes the joint unstable, painful, and stiff, and can even lead to the leg becoming shorter.


What Causes This Condition?

There are quite a few reasons someone might develop Protusio Acetabuli:

  • Bone disorders like Otto pelvis, Paget’s disease, or Marfan syndrome
  • Inflammatory conditions like Rheumatoid Arthritis or Ankylosing Spondylitis
  • Old fractures of the hip socket (acetabulum)
  • Tuberculosis or Osteomalacia
  • Or it could even be present since birth (congenital)

Real-Life Case: A 👩‍🌾Farmer from Mhow, Madhya Pradesh

A 60-year-old farmer came to my satellite OPD at AKJC with complaints of:

  • 😢Pain in the left hip, especially while walking
  • Stiffness in the joint
  • Shortening of his left leg
  • Constant 🌙night pain, worsening for over a year

He had a history of an acetabular fracture 15 months ago and was treated with an acetabular plate.

We got an X-ray and CT scan done and diagnosed him with Protusio Acetabuli. Due to the complexity, we planned a Total Hip Replacement (THR) using special revision implants – just in case we needed more support during surgery.


Why This Surgery Is Tricky

Surgery in such cases isn’t straightforward. Here’s why:

  1. The femoral head (ball⚽) is stuck deep inside the pelvis, making it tough to dislocate during surgery.
  2. The acetabulum (socket) is deeper and wider than usual, so we need larger implants with extra fixation (like more screws or support cages).
  3. There can be gaps or bone loss, which we fill using bone grafts or similar materials.
  4. We also have to be very careful about the muscles, ligaments, and nerves, which are at risk of being overstretched.

Surgery & Recovery

The patient underwent a modular revision hip replacement, and everything went well. Post-surgery, he showed good recovery, improved movement, relief from pain, and regained leg length.


Final Thoughts

Protusio Acetabuli is a rare and complex condition, but with the right diagnosis and planning, a successful hip replacement is possible.

At AKJC – Anupam Khandelwal Joint Clinic, we specialize in treating challenging hip and knee cases with advanced techniques and personalized care.


Need Help with Hip Pain or a Complicated Joint Issue?

👨‍⚕️ Consult Dr. Anupam Khandelwal – Joint Replacement & Orthopaedic Surgeon
🌐 www.dranupamkhandelwal.com
📍 AKJC – Anupam Khandelwal Joint Clinic
📞 Call: +91-8818814030
📧 Email: contact@dranupamkhandelwal.com


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