{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,4,27]],"date-time":"2025-04-27T13:10:04Z","timestamp":1745759404515,"version":"3.40.4"},"reference-count":25,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2018,7,10]]},"abstract":"<jats:p>This is a case of a previously healthy 51-year-old man who sustained bilateral central hip dislocations following a sudden presentation of epileptic seizures. The patient was initially treated conservatively for a period of 9\u2009months. On presentation, he had gross disability due to stiffness in both hips and left peroneal nerve paresis. Through minimally invasive direct anterior approaches, bilateral total hip arthroplasties were performed using tripolar head articulations. These were cemented into a biologic acetabular buttress constructed out of autologous bone graft. The femoral heads and necks were used as plugs and pressed into the acetabular defects, putting the medial acetabular walls under tension. At 24 months\u2019 follow-up, there was a good clinical outcome, and the acetabular walls remodelled bilaterally. In conclusion, in traumatic protrusio acetabuli, a functional, biologic reconstruction of the acetabular wall can be facilitated with the application of distraction osteogenesis (tension-stress) principles while using minimally invasive surgical techniques.<\/jats:p>","DOI":"10.1136\/bcr-2018-225934","type":"journal-article","created":{"date-parts":[[2018,8,1]],"date-time":"2018-08-01T15:05:20Z","timestamp":1533135920000},"page":"bcr-2018-225934","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Delayed presentation of bilateral central hip protrusio acetabuli: evidence-based management"],"prefix":"10.1136","volume":"2018","author":[{"given":"Androniki","family":"Drakou","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8171-5344","authenticated-orcid":false,"given":"Johnathan Robert","family":"Lex","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Markos","family":"Psifis","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nikolaos A","family":"Stavropoulos","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2018,8,1]]},"reference":[{"key":"2025042705465502000_2018.aug01_1.bcr-2018-225934.1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1155\/2012\/820501","article-title":"Literature review and clinical presentation of bilateral acetabular fractures secondary to seizure attacks","volume":"2012","author":"Nehme","year":"2012","journal-title":"Case Rep Orthop"},{"key":"2025042705465502000_2018.aug01_1.bcr-2018-225934.2","doi-asserted-by":"publisher","DOI":"10.1136\/bcr-2015-211445"},{"key":"2025042705465502000_2018.aug01_1.bcr-2018-225934.3","doi-asserted-by":"crossref","first-page":"343","DOI":"10.1007\/s00068-014-0462-z","article-title":"Management of neglected acetabular fractures","volume":"41","author":"Veerappa","year":"2015","journal-title":"Eur J Trauma Emerg Surg"},{"key":"2025042705465502000_2018.aug01_1.bcr-2018-225934.4","doi-asserted-by":"crossref","first-page":"29???37","DOI":"10.1097\/00003086-198406000-00005","article-title":"Reconstruction of the acetabular wall with bone graft in arthroplasty of the hip","volume":"186","author":"Mendes","year":"1984","journal-title":"Clin Orthop Relat Res"},{"key":"2025042705465502000_2018.aug01_1.bcr-2018-225934.5","first-page":"12","article-title":"The results of Charnley arthroplasty of hip performed for protrusio acetabuli","volume":"132","author":"Sotelo-Garza","year":"1978","journal-title":"Clin Orthop Relat Res"},{"key":"2025042705465502000_2018.aug01_1.bcr-2018-225934.6","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1097\/00003086-199603000-00024","article-title":"Bilateral central acetabular fracture dislocations secondary to sustained myoclonus","volume":"324","author":"Van Heest","year":"1996","journal-title":"Clin Orthop Relat Res"},{"key":"2025042705465502000_2018.aug01_1.bcr-2018-225934.7","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1097\/00003086-199002000-00020","article-title":"Reconstruction of the deficient acetabulum using the bipolar socket","volume":"251","author":"Wilson","year":"1990","journal-title":"Clin Orthop Relat Res"},{"key":"2025042705465502000_2018.aug01_1.bcr-2018-225934.8","doi-asserted-by":"crossref","first-page":"405","DOI":"10.1016\/S0883-5403(06)80040-9","article-title":"Bipolar socket in protrusio acetabuli. 3-6-year study","volume":"8","author":"Wilson","year":"1993","journal-title":"J Arthroplasty"},{"key":"2025042705465502000_2018.aug01_1.bcr-2018-225934.9","first-page":"73755","article-title":"Traumatic arthritis of the hip after dislocation and acetabular fractures:treatment by mold arthroplasty. 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