Malpositioned Hardware During Hip Replacement - Early Failure and Revision Surgery

Case Summary

This case involved a 61-year-old veteran who underwent a left total hip replacement. Following the procedure, he developed severe pain and repeated episodes of his hip “popping” in and out of place. A CT scan later revealed that the surgical hardware had been improperly positioned, and a surgical screw extended into surrounding muscle. As a result, a revision surgery was required less than one month after the initial procedure. Despite the revision, the patient was left with permanent pain, functional impairment, and disability as a result of the initial procedure.

Case Details

Mr. Whitney, a 61-year-old veteran, underwent a left total hip arthroplasty (THA) on August 28, 2023 for treatment of degenerative joint disease and osteoarthritis. Prior to surgery, Mr. Whitney had experienced progressive hip and groin pain that failed conservative management, ultimately necessitating surgical intervention.

The procedure was performed using standard prosthetic components, and immediate post-operative imaging was interpreted as showing the prosthesis in satisfactory alignment. Mr. Whitney was discharged home on August 30, 2023 with instructions for rehabilitation and follow-up.

Within weeks of surgery, Mr. Whitney began experiencing mechanical instability, including repeated episodes of his hip “popping in and out of the socket.” At a post-operative visit on September 13, 2023, Mr. Whitney reported multiple such episodes but was advised to continue therapy without further diagnostic workup or intervention despite clear signs of instability.

Days later, on September 18, 2023, Mr. Whitney presented to the emergency department with worsening pain and recurrent subluxation events occurring up to six times daily. Despite these concerning and worsening symptoms, no intervention was performed, and Mr. Whitney was discharged with outpatient follow-up.

On September 20, 2023, Mr. Whitney obtained a CT scan of the left hip that revealed critical findings, including malpositioned acetabular hardware with a surgical screw extending into the iliopsoas muscle. These findings explained Mr. Whitney’s ongoing and persistent instability and pain and confirmed that the original arthroplasty had failed due to improper component positioning.

Due to the failed primary procedure, Mr. Whitney underwent a revision left total hip arthroplasty on September 26, 2023, less than one month after the initial surgery. Despite the revision surgery, Mr. Whitney continued to experience persistent pain, difficulty ambulating, prolonged recovery, functional limitations, and permanent disability.

Following the procedure, Mr. Whitney had a formal “Adverse Event Disclosure” meeting at the hospital attended by several hospital leaders, including orthopedic and administrative personnel. At this meeting, representatives of the hospital acknowledged the complications related to his surgical outcome and expressed regret for the events that occurred. During this meeting, providers acknowledged Mr. Whitney’s ongoing pain and mobility issues and provided information regarding potential compensation options and the paperwork necessary to move forward with such options.

Because the care was provided at a federal facility, Mr. Whitney’s claim fell under the Federal Tort Claims Act. Before filing a lawsuit, claimants must submit an administrative claim using a Standard Form 95. This form notifies the federal agency of the claim and initiates the administrative investigation process. A Form 95 was submitted for Mr. Whitney, which triggered the administrative claims process.

Result

Following review and settlement negotiations, the parties reached an agreement to settle the case for a substantial amount prior to the filing of a formal Complaint.