Ossron(cultured osteoblast) in AVN hip

Above is the xray of a 28 year doctor with pain in lt hip of 3 months duration. The mri showed a gr 2 lesion in lt hip and grade 1c rt hip. We attempted acteocyte culture and at 5 weeks the postop xrays are below. We are awaiting MRI pics to look at revascualrisation. His symptoms are better but that could be due to decompression alone.

 pleasantly surprised

 

Complex Hip- OA with intertroch nonunion with implant in situ

Any takers for this complex hip pics send to me by my good friend 

 He managed put a stem  between the screws had a problem with the  osteopenic trochanter and possibly cup both of which could contribute to instabilty which is what happenend  in time

 Charan whats the problem now and solutions
 as expected  the hip dislocated

The options now
The cup appears too anteverted as well as vertical. . with a flying trochanter adding to the problem.

 my advise is to revise the cup. use larger head if possible and use a trochanteric cable plate.if the troch is too soft to hold  wire over a titanim mesh. if this does not work only a capture cup or a tripolar head is the only solution.

My friend revised the cup and stabilised the hip. his trochanter has dissapeared. In this situation anchor the glutea to the reamaning bone or if that is not possible anchor the two flaps of TFL  to bone  leaving the distal portion free to inset distally. Abductor bace for 6 weeks

11 years post Single bundle PCl reconstruction

 I had the pleasant surprise of  reviewing a patient 11 years after a single bundle Quads tendon isolated PCL reconstruction done while I was at amrita institute. He has no symptoms and works as a project engineer in the oil feilds of oman.
o/e.
PCL was close to gr 2 solid end pt. no meniscal signs or joint tenderness Dial test negative. Xrays show minimal medial compartment narrowing as compared to the normal side. No patellofemoral changes.

Inspite of old technique the PCL recon was worth in a young man. I believe the present day literature support even in isolated PCL injuries more than grade 2.

My