Revision THR
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The document discusses hip replacement surgeries, highlighting reasons for replacement, complications, and surgical challenges. It provides case summaries of patients with issues like broken implants, mal-position, and infected prostheses, emphasizing the necessity for careful planning and specific implants. It concludes that infected prostheses are the most common cause for revision surgeries in this context.
Revision THR
- 1. J K Laik V.Chandra Dept Of Joint replacement and reconstruction
- 2. • Why hip replacement? • How? –Surgery!
- 3. Trauma - Injury Osteonecrosis Rheumatoid arthritis Osteoarthritis Bone tumors that break down the hip joint.
- 4. Generally acknowledged indications: Jointpain Functional limitation Radiographic evidence ofjoint damage
- 13. Removal of Old Component Re-implantation of New Component
- 14. Break of Implant Loosening Implant failure
- 15. Complex Lengthy Challenging
- 16. Most challenging CementRemovalFromFemur BoneGraftingandReconstruction SoftTissueBalancing
- 17. Name – UF Age 68 yrs Previous THR in Chennai in 12 yrs back Admitted for pain and inability to walk
- 18. PRE OPERATIVE AP VIEW
- 19. PRE OPERATIVE LATERAL VIEW SHOWING EXTENDED FRACTURE AND PERFORATION OF FEMORAL STEM
- 20. PROBLEMS SOLUTION Broken implant Cemented Perforated Removal of broken implant Removal of cement Refixation with a new implant
- 21. PRE OP XRAY SHOWING SUBLUXED JOINT
- 24. POST OPERATIVE XRAY AP VIEW
- 25. CASE SUMMARY G T wife of Mr. G She was operated elsewhere for Rheumatoid Arthritis of Right Hip on 3rd November, 11 Cemented Total Hip Replacement was performed and patient was ambulatory for about a month on evaluation was found to be having Mal-position of Replaced Component resulting in Dislocation.
- 28. PROBLEMS Dislocated implant Shortening Cementing SOLUTION Removal of cement Removal of implant Reconstruction with a new implant
- 32. Name – PS,48 yrs THR done in 2008 Aseptic loosening of femoral component
- 42. Name –RNS Age 68 yrs Infected implant
- 52. Name – SG Age 55 Initial surgery for neck of femur done elsewhere Had prior shaft femur fracture (now healed) Surgery abandoned as there was perforation of AMP Cement could not be taken out
- 54. PROBLEMS Cement inside Shortening Old fracture SOLUTION Removal of cement Reconstruction with a newer implant
- 55. WAGNER’S EXTENDED OSTEOTOMY WITH REMOVAL OF CEMENT
- 57. REAMING OF DISTAL DEFORMED FEMORAL CANAL ON A GUIDE WIRE
- 58. REPAIR OF OSTEOTOMY WITH PRESERVATION OF MUSCLE ATTACHMENT AND PROSTHATIC IMPLANTATION
- 59. POST OPERATIVE PICTURE TOTAL HIP REPLACEMENT (WAGNER UNCEMENTED STEM AND UNCEMENTED CUP)
- 60. In our set up the most common cause of revision is infected prosthesis followed by malposition implants and periprosthetic fractures Revision for aseptic loosening is less mainly because most of the patients operated are late in their life Proper planning and availability of implants and instrumentation is a must before attempting such type of surgery