TOTAL HIP REVISION AT HATYAI HOSPITAL
20TH February 2001
Case Details
Patient Name : Mr. P.M
Age : 32 years
Diagnosis : Failed THA left hip
Date of Surgery : 20th February 2001
Operative Details: Revision of Acetabulum Lt Hip with Allograft.
Surgeon Name : Dr. PAIROJ WARACHIT
Hatyai Hospital
Tel: 044-230800-1
Mobile: 01-8964198
Email: Warachit@health2.moth.to.th , warachit@ya.com
Demonstrating Surgeon: Prof. Dr. med. YONGYUDH VAJARADUL
Type of Allograft : Deep Frozen Femoral Heads - 2 Nos
Documentation: Mrs. Thanyawan Aresanasuwan
Fig 1: Pre-Operative X-ray of the patient showing Total Hip Arthroplasty failure
Fig 2: Intra-Operative Approach to the lossening prosthesis showing the prosthesis femoral head and plastic part of Acetabular Cup
Fig 3: Removal of the loosening acetabular component, showing the cavity defect with the stem of the prosthesis still intact. Neck of the prosthesis is clearly visible
Fig 4: The reamed femoral head allograft being applied to reconstruct the acetabulam
Fig 5: Deep frozen femoral head allografts being soaked in normal saline for cleaning purpose before being applied
Fig 6: Femoral Head being scraped to take out the articular cartilage with the help of bone mill
Fig 7: Femoral head allograft after cleaning. The small piece was morselized and the big piece was shaped to fit in the cavity and temporary fixed with 3 K-Wires. Then the acetabulum was reamed with a Number 48 reamer. The reinforcement ring was placed in the cavity with morsellized bone to adapt the shape. The prosthesis was fixed to the illieum by cancellous screws. The prosthesis was fixed with bone cement.
Fig 8: Post-Operative View of the X-ray indcates stable hip after the test on the table. Flexion 90 degrees and extension 20 degrees without dislocation. No leg length discrepency noted.
Fig 9: Lunch and discussion after the surgery. The operative time was 4 hours.