Revision Hip replacement for infection

1
Revision Hip replacement for infection

• Our patient is 72 years old with DM, wheelchair
  bound, with previous 8 operations. Last one was
  done in Germany and had persistent infection for
  last four year.
• He also had significant bone weakness, called as
  Osteoporosis. He also has hypertension and
  Coronary artery disease.

Dr. Hemant Sharma - Best Knee, Hip Joint
Replacement Surgeon in Gurgaon, Delhi NCR, India
www.drhemantortho.com
2
Revision hip surgery for infection

• It has two stages.
• Stage one is removal of old implant with cleaning
  and insertion of temporary antibiotic coated
  spacer.
• Stage two involves removal of spacer and
  reconstruction of bone defect and insertion of
  new hip joint.
• On an average the time difference between two
  stage is 3-4 monts.

Dr. Hemant Sharma - Best Knee, Hip Joint
Replacement Surgeon in Gurgaon, Delhi NCR, India
www.drhemantortho.com
3
Pre-op x-rays, 72 years, previous 8 surgeries on
hip. Hip is infected, pus discharge. Last surgery
done in Germany
Dr. Hemant Sharma - Best Knee, Hip Joint
Replacement Surgeon in Gurgaon, Delhi NCR, India
www.drhemantortho.com
4
Stage 1, removal of Implant
Dr. Hemant Sharma - Best Knee, Hip Joint
Replacement Surgeon in Gurgaon, Delhi NCR, India
www.drhemantortho.com
5
Technique of well-fixed stem removal, with
unicortical osteotomy
Dr. Hemant Sharma - Best Knee, Hip Joint
Replacement Surgeon in Gurgaon, Delhi NCR, India
www.drhemantortho.com
6
CUSTOMISED SPACER, DISTAL FEMUR FRACTURE AT TIME
OF REDUCTION
Dr. Hemant Sharma - Best Knee, Hip Joint
Replacement Surgeon in Gurgaon, Delhi NCR, India
www.drhemantortho.com
7
X-rays after 3 months, infection settled. Distal
femur fracture healing well.
Dr. Hemant Sharma - Best Knee, Hip Joint
Replacement Surgeon in Gurgaon, Delhi NCR, India
www.drhemantortho.com
8
Stage 2 removal of spacer and new implant.
Defect in acetabulum. Reconstructed using iliac
crest, tri-cortical graft.
Dr. Hemant Sharma - Best Knee, Hip Joint
Replacement Surgeon in Gurgaon, Delhi NCR, India
www.drhemantortho.com
9
Post operative X-ray with Dual mobility cup
Dr. Hemant Sharma - Best Knee, Hip Joint
Replacement Surgeon in Gurgaon, Delhi NCR, India
www.drhemantortho.com
10
Thank You For Watching
Dr. Hemant Sharma
FRCS (England), MRCS ( England), DNB (ortho)
Specialist in Revision Lower Limb Arthroplasty,
Complex Hip, Knee and Sports Injury
FRCS (England), MRCS ( England), DNB (ortho)
Specialist in Revision Lower Limb Arthroplasty,
Complex Hip, Knee and Sports Injury
H1, H Block, Orchid Island Rd, Sector 57,
Gurugram, Haryana 122003
Dr. Hemant Sharma - Best Knee, Hip Joint
Replacement Surgeon in Gurgaon, Delhi NCR, India
www.drhemantortho.com