45 year old male with complaints of pain left hip since 2 months, difficulty in walking, Squatting, climbing up and down the stairs, has to walk with help of walker.

Past history- H/o right hip cemented Total Hip Replacement elsewhere. Closed cup placement and Varus placement of Stem noted in Right Hip

Clinical examination: Left hip rotations painful.

Shortening left lower limb.

Patient was investigated. X ray pelvis with both hips was performed and revealed AVN left hip.

SalientPoints

• Important to Identify the defect with Trial Reamer. This will help in estimating the Size of the defect and the area of uncovering
• After putting the Graft, the Trial cup should be placed to Recheck
• Reaming needs to be done after putting the Graft in place as this will ensure that Cup Placement is not Difficult
• Final fixation can be done after Cup Placement