thr in dysplastic hip post pprp

32 year old financially challenged girl with painful hip. She has a foot drop . grade 4+ hip abductors and flexors

problems1. dyspalstic acetabulum

coxa calga

narrow osteoporotic femoral canal.

TKR in a valgus knee with malunited shaft of femur

68 year old gentleman whose xrays below where sent to me for opinion.

Option 1. Ideal case for CAS

option 2. If CAS is not available what next? comments pleaase

poly wear 6 years post thr

this is my own patient done 6 years ago with metal on poly( CLS with sportono cup). 2 week history of thigh pain.
ESR, CRP and cbc are normal. Bone scan shown minimal uptake in the proximal femur( gruen 1 and 5).

Impending fracture post thr

68 year old sister with an aseptic loosening. How can one advise to continue walking innthis case? Are we waiting for the inevitable fracture of femur and posterior column.

Isn't it better to revise early once loosening occurs.

THR in non unon fracture acetabulum

Case sent by C . mahajan

67 year old with 2 year old malunited acetabular fracture planned for thr

problems.

1. Is the fracture united - if not in situ posterior column plating single or double.

2. Cavitatory defect with posteriosuperior migration. peripheral reaming to widen the acetabular mouth to fix a peropheral fitting cup and particulate grafting of the cavity. The union to could be assesd from the floor.

Implants. - keep larger cups as well as pinnacle revision cup back up in case.

Gages may not be needed.

Dr mahajan felt that the acetabulum was united and did an uncemented cup without screws. He was confident of the stabiilty. I would have been comfotable with screw at least 2 of them as well as posterior plates if there was any doubtof column union. I need to get his permission to upload the post op pics

jacob