painful hemiarthroplasty

 

 

 

 

 

 

 

 

 

The pain could be in the groin or thigh. if there is no rest pain it has to be as expected aseptic loosening. I would hesitate to put an uncemented AMP in a physiogical 60 as all evidence points to a THR can get better results if there is  no dislocation

                                                                                                 

One needs to rule out infection with the CRP/ ESR with aspiration and luecocyte esterase test. if not infected a one stage THR. My choice would be  to  do an uncemented cup with vit E poly,36 head and an uncemented fully HA coated  high offset stem if i can get good fixation. I need the opposite HIP xray to measure the offset -green line. if cemented stem is used consider roughening the endostium to  get cement interlock.

 

send at least 6 cultures of tissue,fluid in bactec as well as  check for fungal cultures( remember the cheatles forceps used in some ORs which need to be banned).