55 years old lady came to us with complaints of pain in right hip with shortening of 5 cm. She had a hip replacement 40 years back which had failed. She was barely managing with a walking stick till now. She had severe pain for the last 6 months. We performed Total Hip Replacement. The acetabulum bone was inadequate which had to be supported with a special implant called Mueller’s Ring into which a poly cup was cemented. The shortening was also corrected and she now has a pain free stable hip.
55 years old lady came to us with complaints of left hip pain and difficulty in bearing weight on left lower limb for the past 3 months. She underwent hip replacement surgery (THR) in 1995 followed by revision THR (2000 & 2008) elsewhere. On Clinical examination there were no signs of infection. There was shortening of 4 cm on left side.
Infection markers were negative. Preoperative x ray showed aseptic loosening of both acetabular socket and femoral stem. There was huge defect in acetabulum.
We further evaluated this case with CT scan which showed large anterior and superior bone defect while the posterior bone stock was good. We also prepared a 3D model of acetabulum preoperatively to study the defect and procure all the implants as backup for filling the defect. This 3D model was made under the guidance of Dr Shekhar Agarwal and team.
3D printing is the latest technology in Orthopaedics where we can have actual 3D model of bone and plan our surgery accordingly. 3D model exactly replicates actual bone defects which helps the surgeon to plan the surgery.
At Sant Parmanand Hospital we have this facility of 3D printing that we use in cases of difficult surgeries. As per our preoperative planning we did revision Total Hip Replacement (THR). Allograft bone was used to fill the acetabular defect and Trabacular metal jumbo acetabular cup was used. Uncemented long stem Wagner femoral stem was used on the femur. Now patient is comfortable and walking 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.
At Delhi Institute of Trauma & Orthopaedics, in Sant Parmamand Hospital, we perform very complex knee and hip replacement surgery. One of the most complicated types of joint replacement surgery is revision hip replacement surgery. This surgery involves removing a previous implant that was in the hip joint that has become damaged due to injury or wear and tear and replacing it with new more advanced hip implants. This requires extremely high surgical technique and the surgery can often last many hours as the surgeon has to take many factors into consideration such as the age of the patient, the type of bone quality he observes in the patient, and the extent of damage found inside the joint or adjacent areas.
As an example, a 53 year old gentleman was presented to our hospital with pain in the right hip following a road traffic accident. He had a total hip replacement done 10 years prior to the accident and was walking comfortably before the accident. X-rays revealed a fracture of the pelvic bone (acetabulum) with posterior dislocation of the acetabular component. Fixation of the acetabulum fracture with screws followed by revision of the acetabular component with an uncemented cup was performed. As the femoral component was well fixed, it was not revised.
Essentially in this patient, we had to revise one component of the hip implant, and add screws in the pelvic area to give support to that area so that the bone unites where fractured. Post operatively, the patient is walking comfortably.
Delhi Institute of Trauma & Orthopaedics is one of the leading orthopaedic hospitals in India. Our teams of surgeons are dedicated to learning and practicing the most advanced surgical techniques and handling the most complex surgical cases.
Helena Ashmore R/o UK aged 80 years had her total hip operation done in the UK. After her operation, she had several complications as she suffered from another disease called Myositis for which she was advised radiotherapy. She was refused any type of surgery in the UK. Meanwhile,her hip continued to worsen and pain increased. She came to us hoping for an alternative. A revision uncemented total hip replacement was done, and she was discharged from the hospital. She has is now walking comfortably on her new hip.
Personal Testimonial: I have been overwhelmed by the kindness of everyone during my stay. I cannot express my gratitude for all of those who have been involved. If I had not found Dr. Shekhar through Medindia Connect, I would not be walking. A big thanks to you and bless you all.
Mrs.Al-Mushaikhi R/o Oman aged 82 years came to us with severe arthritis of her shoulder joint. She had complete stiffness of her shoulder and could not move it. This type of arthritis is very rare and it required a special type of surgery. She received a total shoulder replacement, which after surgery, successfully allowed her to move her shoulder again. After 6 days stay at the hospital, she was discharged and was on a flight back to Oman.
Her Son’s (Dr.Khalid Al-Mushaikhi) testimonial: I would like to express my thanks to Dr.Shekhar and his team for his keen attention and staff cooperation. My stay here was very comfortable. The staff was extremely helpful and service levels were extremely good. My thanks to all.
Samira 20 yrs old girl from Kabul, Afganistan had a dysplastic hip from birth resulting in shortening of the limb. She had started to develop pain due to degenerative arthritis in the last few years. Fusion of the hip was tried at Kabul but did not cure her of the pain. She underwent successful Total Hip Replacement by a special approach. After the surgery she regained her movements at the hip and the length of the leg increased. She is now able to walk without support and cane.
Personal Testimonial: I am extremely happy that I got this surgery done, as now I have no problem with walking and I no longer need a walker. There is no pain as well. The doctors were excellent and extremely helpful. God bless all of you.”