The above images were sent to me for advise
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There Is superiomedial migration of the cup compromising the anterior column. The posterior column and wall appears ok. One could consider trabecular metal wedges graft and a cup construct in younger patients as there is no dissociation and posterior column and cup is intact. This patient is 80 years old hence I would prefer a birsch schnider cage and a cemented cup. I would bent the inferior flange of the cage to act as hook on the tear drop and fix dome screws first to stabilise the cage before the superior flange is fixed. The cemented cup can be cemented independent of the cage in correct inclination and anteversion. A bit of. cement uncovering is aceptable.
Surgical approach would be posterior?
ReplyDeleteSir, Dr S Rajagopal, Chief Cardiothoracic Surgeon from Amala hospital has recommended you when i inquired about Knee replacement for my aunt. I would like to know whether you will be operating in Kerala in these months?
ReplyDeleteI was First Assistant/Surgeon Assistant with Dr Rajagopal for 4 years. My email id is jijilizthomas@gmail.com
Yes shiva, easier to dislocate and remove the cup as it has migrated anterioly as well as to use a cage a posterior approach would be ideal. In case one falter on a harbinger approach a trochanter if flip would improve posterior exposure
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