Rzyczniok P, Dugiełło B, Rokicka D, Szczęśniak M, Ochocki K, Kucharski R, Wróbel MP, Mazur W, Strojek K, Stołtny T. Revision total hip arthroplasty after two liver transplantations: A case report. World J Orthop 2026; 17(9): 119101 [DOI: 10.5312/wjo.119101]
Corresponding Author of This Article
Bogdan Dugiełło, MD, District Railway Hospital, Medical University of Silesia, No. 65 Panewnicka Street, Katowice 40-760, Poland. bogdan.dugiello@gmail.com
Research Domain of This Article
Orthopedics
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case-report
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Rzyczniok P, Dugiełło B, Rokicka D, Szczęśniak M, Ochocki K, Kucharski R, Wróbel MP, Mazur W, Strojek K, Stołtny T. Revision total hip arthroplasty after two liver transplantations: A case report. World J Orthop 2026; 17(9): 119101 [DOI: 10.5312/wjo.119101]
World J Orthop. Sep 18, 2026; 17(9): 119101 Published online Sep 18, 2026. doi: 10.5312/wjo.119101
Revision total hip arthroplasty after two liver transplantations: A case report
Paweł Rzyczniok, Bogdan Dugiełło, Dominika Rokicka, Maciej Szczęśniak, Karol Ochocki, Rafał Kucharski, Marta Patrycja Wróbel, Włodzimierz Mazur, Krzysztof Strojek, Tomasz Stołtny
Paweł Rzyczniok, Maciej Szczęśniak, Karol Ochocki, Rafał Kucharski, Tomasz Stołtny, Department of Trauma Surgery and Orthopaedics, District Hospital of Orthopaedics and Trauma Surgery, Piekary Śląskie 41-940, Śląskie, Poland
Bogdan Dugiełło, District Railway Hospital, Medical University of Silesia, Katowice 40-760, Poland
Dominika Rokicka, Marta Patrycja Wróbel, Krzysztof Strojek, Department of Internal Medicine, Diabetology and Cardiometabolic Disorders, Faculty of Medical Sciences Zabrze, Medical University of Silesia, Zabrze 41-800, Poland
Włodzimierz Mazur, Clinical Department of Infectious Diseases, Medical University of Silesia, Chorzów 41-500, Śląskie, Poland
Author contributions: Stołtny T designed and coordinated the study; Ochocki K and Szczęśniak M performed the surgical procedure; Rzyczniok P collected the clinical data and drafted the manuscript; Kucharski R provided the anaesthesiologic management and perioperative care; Dugiełło B contributed to the study design, correspondence with the journal, manuscript preparation, and revisions; Rokicka D, Wróbel MP, Mazur W, and Strojek K contributed to the multidisciplinary patient management and data interpretation; Rzyczniok P and Stołtny T analysed the data and prepared the final manuscript; All authors have read and approved the final manuscript.
AI contribution statement: No AI tool was used to plan the study or to generate the scientific content of the manuscript.
Informed consent statement: Written informed consent was obtained from the patient for publication of this case report.
Conflict-of-interest statement: All authors declare that they have no conflicts of interest related to this manuscript.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Corresponding author: Bogdan Dugiełło, MD, District Railway Hospital, Medical University of Silesia, No. 65 Panewnicka Street, Katowice 40-760, Poland. bogdan.dugiello@gmail.com
Received: January 19, 2026 Revised: April 19, 2026 Accepted: August 20, 2026 Published online: September 18, 2026 Processing time: 233 Days and 15 Hours
Abstract
BACKGROUND
Revision total hip arthroplasty (THA) in liver transplant recipients is rare and represents a significant clinical challenge owing to chronic immunosuppression, multiple comorbidities, and increased perioperative risk. Careful assessment of comorbidities and multidisciplinary perioperative management are essential to optimize clinical outcomes in this high-risk population.
CASE SUMMARY
We report the case of a 77-year-old man with a history of hepatic failure due to decompensated chronic hepatitis B infection who underwent two liver transplantations. The patient presented with recurrent dislocation of a right hip prosthesis and a periprosthetic fracture, accompanied by significant pain and limb shortening. Multidisciplinary preoperative optimization was performed. Revision THA was performed successfully. Postoperatively, the patient demonstrated improved mobility and reduced pain. At 6 months after surgery no recurrent dislocation, periprosthetic infection, or implant-related complication was observed, and liver graft function remained stable. The Harris Hip Score was 68, the Visual Analog Scale score was 0, and the Short Form-12 score was 18. Despite multiple risk factors for osteoporosis, densitometry did not confirm reduced bone mineral density.
CONCLUSION
Revision THA in liver transplant recipients can be successful despite high perioperative risk. Individualized multidisciplinary management and careful perioperative planning are essential to functional outcomes in this complex patient population.
Core Tip: Revision total hip arthroplasty (THA) after liver transplantation (LT) is extremely rare and represents a major clinical challenge due to chronic immunosuppression, multiple comorbidities, and a high risk of perioperative complications. We present a case of a patient who previously underwent two LT for chronic hepatitis B and later required revision THA owing to recurrent prosthesis dislocation and periprosthetic fracture. Clinical outcomes were assessed using functional scales, including the Harris Hip Score and the Visual Analog Scale for pain, demonstrating significant postoperative improvement. This case highlights the importance of multidisciplinary management and careful perioperative planning in high-risk transplant recipients.
