Re-Revision Complex Total Hip Replacement

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.

Re revision complex total hip replacement

Revision Hip Surgery can be Complex

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.