Total Hip Replacement (Dual Mobility)

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.

 

Total Hip Replacement Dual Mobility

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

Uncemented dual mobility constrained cup with long stem Total Hip Replacement

50 years lady presented with history of multiple times surgically intervened ipsilateral fracture neck of femur and shaft of femur right lower limb. She presented to us with complaints of pain in right hip region and difficulty in bearing full weight on right leg.

Present xray showed united fracture shaft of femur with plate in situ and nonunion osteotomy site with plate in situ

We did uncemented dual mobility constrained cup with long stem Total Hip Replacement

Now patient is walking comfortably with walker.

Dysplastic Hip Uncemented-Total-Hip-Replacement

60 years female presented to the OPD with progressively increasing pain and limp right hip region for the past 2 yrs.

On examination she had severe deformities of the hip with 3 cm shortening. She was barely able to walk without support

Radiographs showed secondary OA right hip (severe dysplasia)

Management of dysplastic hip is tricky as locating true acetabulum in these cases can be difficult and challenging. Also soft tissue are severely contracted and there is alteration in the morphology of femur & acetabulum. We have done Uncemented Total Hip Replacement with acetabulum at anatomical position which requires expertise.

Now patient is walking comfortably with walker and without limp.

Dysplastic Hip Uncemented-Total-Hip-Replacement

Total Knee Replacement-Revision(TKR)

case-study4DEC-2015:
A 48 year old gentleman underwent bilateral primary Total Hip Replacement in 1994. A revision Right Total Hip Replacement(THR) was done in 1997 due to early component loosening. He was comfortable for the last 15 years. He presented to us with complaints in hip and thigh region since last 1 year. Pain had progressively increased over a period of time. On examination there was no gross instability or any evidence of infection. X-rays showed loosening of the femoral component.
A re-revision Total Hip Replacement with uncommented acetabular cup and long uncommented Wagnerstem has been done. Patient was comfortable and walking with a frame at 2 weeks.