title: Irreducible dislocated total hip replacement due to intra-articular incarceration of bone cement: A case report.
abstract: BACKGROUND
  Dislocation following total hip replacement is a well-documented complication. We present an unusual cause of failure to achieve a concentric closed reduction of a cemented total hip replacement which has never previously been reported.
  
  
  METHODS
  A 78-year-old female patient had an unsuccessful closed reduction of a posteriorly dislocated total hip replacement. Careful review of perioperative radiographs revealed a fragment of bone cement incarcerated within the acetabular component blocking reduction. This was confirmed on a subsequent computed tomography scan. Open reduction via a posterior approach with retrieval of the cement fragment was eventually required.
  
  
  CONCLUSIONS
  Observation of important radiological features which may prevent unnecessary further attempts at closed reduction are discussed. We consider reasons for a non-concentric reduction and reflect on the dangers of multiple forced attempts.
  
  
  CONCLUSIONS
  This case emphasises the importance of clinical judgement during closed reduction and highlights a previously unreported cause for non-concentric reduction in a dislocated cemented total hip replacement.
authors.affiliation: Department of Trauma and Orthopaedics, Bradford Royal Infirmary, United Kingdom. Electronic address: limhaifon@gmail.com.
authors.forename: Hai Fon
authors.initials: HF
authors.lastname: Lim
authors.affiliation: Department of Trauma and Orthopaedics, Bradford Royal Infirmary, United Kingdom. Electronic address: Sameer.Jain@bthft.nhs.uk.
authors.forename: Sameer
authors.initials: S
authors.lastname: Jain
authors.affiliation: Department of Trauma and Orthopaedics, Bradford Royal Infirmary, United Kingdom. Electronic address: Ben.Haughton@googlemail.com.
authors.forename: Ben
authors.initials: B
authors.lastname: Haughton
authors.affiliation: Department of Trauma and Orthopaedics, Bradford Royal Infirmary, United Kingdom. Electronic address: Veysi.Veysi@bthft.nhs.uk.
authors.forename: Veysi
authors.initials: V
authors.lastname: Veysi
authors.affiliation: Department of Trauma and Orthopaedics, Bradford Royal Infirmary, United Kingdom. Electronic address: David.Shaw@bthft.nhs.uk.
authors.forename: David
authors.initials: D
authors.lastname: Shaw
keywords: Bone cement; Dislocation; Hip replacement; Instability