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Cemented total hip arthroplasty for neglected acetabular fracture with femoral head collapse in an elderly patient – a case report

Year: 2026

Type: article

Abstract: Introduction: Neglected acetabular fractures associated with femoral head collapse are uncommon in elderly trauma and present major reconstructive challenges. Total hip arthroplasty (THA) remains the definitive solution once acetabular healing is complete. There is a lack of research on the clinical results of THA in cases where acetabular fractures have been overlooked. Case presentation: A 72-year-old man presented 4 months postinjury with persistent right hip pain and inability to bear weight. CT scan and X-rays showed a right femoral head fracture with anterior and posterior column involvement of the acetabulum, including the medial wall, and complete joint destruction with post-traumatic osteoarthritis. The acetabular floor had healed in malunion and appeared solid. He underwent right cemented total hip arthroplasty (THA). Intraoperatively, vertical and horizontal offsets were optimized by achieving an optimal press-fit of the femoral stem based on intraoperative stability assessment. Physiotherapy began on the first postoperative day, and full weight-bearing ambulation with crutch support was permitted. At 6-month follow-up, the patient was walking independently with a pain-free, stable joint, and had returned to his daily work. Discussion: Late-presenting acetabular fractures are technically challenging due to malunion and bone loss. In elderly patients, cemented THA offers immediate stability, reliable fixation in osteoporotic bone, and early mobilization. Offset optimization and correct component orientation are key to restoring function and minimizing complications. Conclusion: Cemented THA is an effective and durable treatment for neglected acetabular fractures with femoral head collapse in elderly patients, enabling early rehabilitation and excellent functional recovery.

Source: International Journal of Surgery Case Reports

DOI: 10.1097/rc9.0000000000000300

Authors: Rohil Singh Kakkar, Ananya Pareek, Rohan Maske, Vinayak Garje

Institutions: Eternal Hospital, Noble Hospital

Language: English

Topic: Orthopaedic implants and arthroplasty

Subfield: Surgery

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,090