66 years old lady presented with pain, limp and inability to bear full weight over left lower limb for the past 1 year.
Patient had history of surgical intervention done elsewhere in view of proximal femur fracture 1 year back. Fracture was fixed with short PFN A2. Surgical site has been healed with primary intention and has no sign of infection. Her blood investigations were also come to be within normal limits.
Present X-Ray showing non union fracture proximal femur with Failed PFN in situ.
Thus planned for PFN removal and conversion to UNCEMENTED (DUAL MOBILITY) THR with long stem to bypass the distal screw.
Post op showing well press fit uncemented Total Hip Replacement (THR) with dual mobility cup to enhance the stability. These cases are challenging due to presence of ununited fracture in proximal femur and needs extra care for stability. We routinely do these cases with good outcomes using special dual mobility cup concept.
Now patient is happy, walking comfortably with support.
57 year old gentleman came to us with complaints of pain in right hip region and inability to walk and bear weight over right lower limb. Patient had past history of trauma to right hip region in the form of fracture acetabulum for which patient underwent primary fixation and Total Hip Replacement elsewhere in 2018. Subsequently patient developed dislocation of right Total Hip Replacement (THR) and underwent revision of acetabulum constrained component at our institute. Patient developed surgical site infection and re-dislocation of previously done hip and came to us for further management.
Pre-op X-Ray pelvis with both hip joints showed dislocated hip with implant in situ
Patient planned for meticulous debridement and definite management for recurrent dislocation of hip. These complex cases required appropriate surgical planning and special surgical instrumentation. Because of previously done multiple surgeries leads to laxity of soft tissues and increases the risk of infection.
This patient underwent thorough surgical site debridement to wash out the infection and one stage re-revision Total Hip Replacement (THR) was done using cemented constrained acetabulum. The femoral stem was also revised to a cemented stem.
77 year old gentleman had underwent Right total knee replacement in 2017 elsewhere in view of secondary Osteoarthritis (post tubercular). Subsequently patient developed surgical site infection after 3 months of the index procedure and came to us with no relief in symptoms.
We have done 1st stage debridement and cemented mobile spacer was inserted in 2019. After 2 months of subsidence of infection, 2nd stage specialized revision implant (rotating hinge knee) was done. At follow up – Patient is asymptomatic and walking with support.
57 yrs old gentleman came to us with complaints of right hip pain and inability to wear weight over it. Patient had past history of trauma with sustained injury to right hip 5 months ago in the form of acetabulum fracture that was managed conservatively elsewhere.
Pre op X-Ray suggested of malunited acetabulum with AVN of femoral head thus planned for Total Hip Replacement.
These cases require meticulous pre op planning and special implants hip system for stability.
Post op X-Ray showing uncemented Total Hip Replacement (THR). Now patient is walking comfortably.
72 years old lady with past history of bilateral knee replacement (Right knee was replaced 6 months ago). Presented with pain right knee region and difficulty in bearing weight over right leg following history of fall at home. Preop X-Ray was suggested of fracture of distal femur around previous implant.
This is a very challenging case due to fracture in presence of previous implant. It needs special surgical planning and implants to replace the deficient bone stock. We regularly do these type of cases with good functional outcomes. Post op X-Ray showed distal femur replacement with hinge prosthesis. Now patient is walking comfortably with walker.