THE CASE

A 25-year-old, Iraqi lady came to India to find the right treatment for her Dysplastic Hip Joint. She had undergone an unsuccessful Hip Replacement Surgery in her country. Much to her dismay the surgeon was unable to identify the true socket and erroneously developed another socket in the iliac wing of the pelvis and implanted an acetabular cup much above the true acetabular socket. Accordingly, the femoral shaft was also shaped and shortened to match this cup and a total Hip Joint was constructed along the ilium. The Hip failed within no time with total disruption of the joint causing more misery to the Iraqi lady. She was bedridden for one year and later came to BLK Super Speciality Hospital, India to find the right cure.

THE PROCEDURE

The team at BLK was confronted with the task of salvaging the Hip and providing her a stable construct on which she would be able to walk again. A surgery was performed to remove the old acetabular cup with all its screws and debris. The index acetabulum was identified by imaging techniques. The dysplastic acetabulum was reamed and reconstructed with bone grafts and then a 'Tripolar Acetabular Cup' was implanted in correct version and inclination. The bigger challenge was yet to come with the high riding femoral head, which was about 4 to 5 cms above the newly constructed acetabular rim. There were severe muscle contractures and scarring from previous surgery that did not let the femoral head reduce in the acetabular socket. After wide soft tissue releases and stripping the soft tissue up to the mid shaft of femur, the reduction of the femoral head was accomplished and a stable construct was achieved, thus, salvaging a difficult situation.

THE RESULT

After the surgery the patient was very relieved and her discomfort was almost gone. The revision surgery gave her a new hope to lead a normal life. She is happy, healthy and all geared up to give a fresh start to her life.