A collection of complex joint preservation and replacement case studies and random thoughts of a orthopedic surgeon essentially aimed at knowledge dissemination.
Wednesday 9 February 2011
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.
She was advised to continue with the loose implant. This sort of advise is criminal as she has an impending fracture as well as major acetabular bone loss. Ur are right as to say that the rev surgery is the surgeons call.
As far as revision goes we did a pinnacle revision cup with solution stem. The stem size 15 appeared loose after trialing tight with the trials. We cemented the distal stem after removing the porcoat with a bur and acetabular reamer to hopefully avoid early loosening at the cement bone interface.
1)why should any one advise to wait in this case.. isn't revision always the surgeon's call unlike primary?
ReplyDelete2) was it cuz she's bed ridden or something (with some advanced RA or something??)..what was indication for the B/L replacement?
She was advised to continue with the loose implant. This sort of advise is criminal as she has an impending fracture as well as major acetabular bone loss. Ur are right as to say that the rev surgery is the surgeons call.
ReplyDeleteAs far as revision goes we did a pinnacle revision cup with solution stem. The stem size 15 appeared loose after trialing tight with the trials. We cemented the distal stem after removing the porcoat with a bur and acetabular reamer to hopefully avoid early loosening at the cement bone interface.