Bilateral Total Hip Replacement

42 years old gentleman presented to us with pain in both hip joint for the past 4 years with limp. On examination Range of motion both hip joint were painful and restricted terminally and was unable to walk without support.

He had undergone uncemented Total Hip Replacement for both hips (same stage).  He is walking comfortably with the walker.

bilateral-total-hip-replacement

Total hip Arthroplasty ( Dual Mobility)

75 years old lady History of trauma to left hip region in the form of fracture acetabulum which was surgical intervened in March 2018.

After 3 months patient developed pain and limp in left hip region with difficulty in walking. On examination flexion deformity at left hip with restricted rotation and shortening was about 2.5cm.

Pre-Op x-ray shows medialization of femoral head and secondary osteoarthritis.

We did Tripolar ( Dual Mobility) uncemented Total hip Arthroplasty.

Patient is walking with walker with no complications on table.

Total-Hip-Arthroplasty-Dual-Mobility

Revision Total Knee Replacement ( RHK)

65yrs female k/c/o CAD,HTN,RA H/o bilateral TKR done in 2005. Presented to us with c/o pain in left knee with inability to bear weight over left lower limb and was wheel chair bound for the past 5 months .
On examination skin condition was normal , no sign of inflammation with mild effusion Varus instability present with Passive Rom 10 to 120 degree
Current xray shows tibial tray subsidence with loosening with varus collapse of proximal tibial bone Blood infection markers were within normal limits.
Plan for revision TKR left knee. Intraop medial defect was found on tibial side with uneven tibial surface after removal of the component Femur side component was also found to be loose with ligamentous imbalance. So RHK revision TKR was performed using medial half block on tibial side to augment the defect with stem extension and while on femur side normal component with stem extension used and inserted with cement.
After the surgery, the deformity of knee has been corrected and balanced and she has regained full and stable range of movement. She is walking comfortably.

Revision TKR using Link Locking Prosthesis

84 yrs /f had underwent bilateral TKR in 2014. Left side knee got infected after 6 months postoperative period for which multiple debridement done but infection didn’t subside so stage 1 revision left sided done using cement sapcer in 2018. Infection subsided and patient was planned for stage 2 revision TKR using Link Locking Prosthesis after 6 months of antibiotic free period with no infection at surgical site

  • Stage 2 revision done with using Link Locking hinge knee Link prosthesis with cement and closure done in layers
  • After the surgery, the deformity of knee has been corrected and she has regained full and stable range of movement. she is walking comfortably.
  • Revision TKR in the scenario of infection is challenging. At our center we have successfully managed many such cases.

Revision-TKR-using-Link-Locking-Prosthesis

Primary Complex Knee – Proximal Tibia Fracture

53  years old gentleman presented to us with complains of pain and deformity (ROM 20-110) of left knee .  With past history of proximal tibia fracture which was surgical intervened with plate . Subsequently patient developed infection due to which plate was removed elsewhere. After 1 year infection settle down.

Present x- ray shows post traumatic osteoarthritis knee with loss of articular surface of proximal tibia.

We did Total Knee Replacement with LCCK  ( Semi Constrained ) on left side  with tibial side stem extension and graft augmentation for noncontained defect in the postero lateral surface of tibia.

After the surgery, the deformity of knee has been corrected and he has regained full and stable range of movement. He is walking comfortably.

Primary-Complex-Knee