Management of radiation induced, bilateral Primary THA loosening with an aseptic Paprosky Type IIB acetabular defect and a contralateral septic Type IIIB acetabular defect: A case report and review of literature

Primary THA in an irradiated hip poses risk for early loosening and inadequate ingrowth.Adverse effects such as decreased vascularity and increased infection risk pose a threat. Our patient was a case of post-irradiation (for cervical cancer) bilateral THA loosening causing aseptic acetabular loosening on one side and catastrophic septic loosening with a Paprosky type IIIB acetabular defect with pelvic discontinuity on the contralateral side. There have been various studies documenting deleterious effects of irradiation on osseointegration and provide a challenge for long-term implant stability in THA patients. A meticulous treatment protocol with contemporary implant technology and staged bilateral stepwise management can lead to satisfactory clinical outcomes.This case report highlights on such specific nuances and principles.