Joint Replacement | Spine | Trauma Solutions

A 78 year old Patient had an RTA and sustained a Hip injury. He was diagnosed as having a Central fracture dislocation (Bicolumnar Fracture). He was not operated by the treating Orthopedic Surgeon considering the Risks involved at the Age. He presented to us after 7 months with ProtrusioAcetabuli with AVN of Femoral head.

His major Complaints were:

  • Severe restriction of daily activities
  • Night pain and Rest Pain
  • Difficulty in Sitting and Getting up

PLATE XRAY

 

Pre Op Xray

Discussing the risks involved, the Patient was asked to undergo a hip replacement to alleviate his symptoms.

CT Pelvis was done to get a better understanding of the defects.

CT 1

CT 2

CT 3

CT findings :

  • S Defect in anterosuperior wall
  • Posterior wall was intact
  • Defect in anterosuperior part of head

Challenges of Surgery :

  • Defect Reconstitution
  • To get the Perfect Rim fit
  • Early mobilization considering the advanced age
  • Restoring near normal Hip Centre

Operative Pearls:

  • It was decided to use a Trabecular Metal cup and Uncemented Stem on the Femoral side Head and neck
  • The graft was Fixed with the Screws through the cup
  • Rim fit Gription Cup was placed and sufficient lateralization was achieved

Post OP Xray