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

Bilateral Total Hip Replacement

52 years old gentleman presented to us with pain in both hips and difficulty in walking.. On examination he had gross restriction of movements of both hips and was unable to walk without support.

After Radiographic  examination x- rays  show bilateral AVN of both hip joints.

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

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Re-Revision Total Hip Replacement

71 years old female presented to us with recurrent dislocation of right hip following right Total Hip Replacement for fracture Neck of femur in 2009. Patient underwent closed reduction successfully but again dislocated for which acetabular cup was revised in Oct 2018. Despite of that patient dislocated again.
Management of recurrent dislocation after total hip replacement is challenging due to high incidence of redislocation
We did Re- Revision Total Hip replacement with filling of the acetabulr defect with trabecular metal cup and we used burch Schneider cage and cemented cup. Stem was not revised. Postoperatively patient is comfortable and walking with the help of walker.

re-revision-total-hip-replacement-by-dr-shekhar-agarwal

Total Hip Replacement  in  Post Acatabulum Fracture Fixation

56  years old gentleman, known case of parkinsonism is a follow up case of anterior column plus posterior wall fixation for fracture left acetabulum presented to us with complaints of severe pain in left hip with difficulty in walking and managing routine activities.

After proper evaluation patient was counselled to undergo Left Total Hip Replacement . THR in post acetablular fracture fixation is a bit challenging and require special expertise.

Patient was mobilised the next day with walker and is comfortable and pain free.

total-hip-replacement-by-dr-shekhar-agarwal-13-09-18

Total Hip Replacement – Girdlestone

81  year old gentleman  presented with pain in right hip and complaints of inability to walk since last 2 yrs. Patient had a history of fracture neck of femur for which THR was done which subsequently got infected and complete implant removal was done 2 yrs back. This procedure is called girdlestone.

Patient now presents with pain in right hip and is bedridden. This is a challenging surgery as complete anatomy of hip is distorted and requires expertise. After proper counselling he underwent right total hip replacement and is mobilized independently as early as possible.

 

Total_Hip_Replacement-by-Dr-Shekhar-Agarwal