46 year old lady sequale of infective arthritis with fused hip underwent Uncemented Total Hip Replacement 2 months. She had postoperative dislocation of the hip joint. Managing post op dislocation after Total Hip Replacement is challenging and requires loads of clinical experience. Identifying the cause of dislocation is critical to prevent redislocation of hip joint.
Closed reduction under anaesthesia was not possible for this patient so we attempted open reduction . we revised the acetabular cup from conventional cup to Dual mobility cup to reduce redislocation .
Post operatively patient is comfortable and walking with walker.
Lectures & Case Studies
Non-union Tibia With Arthritis Knee
(APRIL:2016)A 60 year old gentleman presented with ununited fracture of leg bone (tibia). He also had pain in knee joint prior to surgery. He was bedridden since last 1 year.Usually uninvited fractures are treated by repeat surgery (nailing/ Plating) & Bone grafting. But this patient also had arthritis of the knee joint, therefore we planned for Total Knee Replacement with long stem in tibia to bypass the fracture site. This surgery require a lot of expertise and experience. Post operatively patient is out from bed and ambulating with walking frame comfortably.
Total Knee Replacement-Revision(TKR)
DEC-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.
Left Periprosthetic Femur Fracture
Case Study
FEB-2016:
SM 62 years female (follow up case of left Total Hip Replacement in 2010) fell down at home and sustained periprosthetic fracture of femur. With increasing number of hip replacements periprosthetic fracture are also becoming common. Managing this fracture is difficult as they are prone to delayed and non union. We routinely get patients with periprosthetic fracture in our department and with time we have gained expertise in treatment of these fractures. In this patient, implant was well fixed so we did Open Reduction and internal fixation (long reverse Distal Femoral Locking Plate). Patient is comfortable and walking with walker.
Total Hip Replacement
Case Study
DEC-2015:
34 years old lady had developmental dysplasia of right hip. She had limp while walking since childhood for which she was operated 3 times . She now had difficulty in walking and her right leg was short by 6 cm. We did Uncemented Total Hip Replacement in which we create new artificial joint. Total Hip Replacement in dysplastic hip is technical challenging surgery and very few centers across India are successfully performing this surgery. Now her legs are equal and her walk has improved. She is very happy with the result of operation.