26 years post conservatively treated acetabular fracture with pain and Limp

•  Used Patients femoral head with a reverse  L cut to fill the posterior wall defect and a uncemented THR was done in 2002. the xrays below are at 18 years with no symptoms but superior linear wer is an issue and has to be followed up closely. The AML stem metal head 22 mm head with standard poly was the only available solution in 2002 in india. one had to push hard on  JNJ to bring in larger ceramic bearings  those days

 CT and Xray taken 19 years later with no symptoms. shows  predictable superior wear  with no periprosthetic lysis. the older standard polyethylene and 22.5 modular head in a very active gentleman

Painful flail lt knee post PPRP in 52 year old

52 yr old lad PPRP  had THR  rt side due to pain in a dysplastic hip 8 yrs back. followed by periprosthetic fracture 2 yeasr post op. Nov presents with pain lt knee at rest worse on wlking. cannot tolerate pain any more in the lt flail knee.  Attempted bracing to prevent the 30 degree hyperextension with no relief. Hence an RHK was done to eliminate pain and improve her gait secondarily.  In a flail limb do we do a rotaing hinge or simple hinge. the literature is a bit grey. we need a 5 degree recurvatum with a further stop ideally. We improved her gait and relieved pain for now with a link RHK with recurvatum stop

 

THR in a posterior wall fracture with damaged head

medialise the cup and got primary UN cemented cup and THR

 

HIP REPALCEMENTIN FRESH ANTERIOR COLUMN FRACTURE

 84 YR OLD ACTIVE LADY WITH AN ACUTE ANTERIOR COLUMN FRACTURE

 a ganz cage with host bone conatct and dome screws and cemented THR done to immediately mobilise the elderly and get her home without issues ASAP

Stiff Painfull knee post trauma

50 year old photographer  with a painful stiff knee 11 year post conservative treated femoral fracture

Options of fusion/ replacement with inherent risk of failure/infection and non union was discussed.  Did not expect this avulsion fracture of patella and tibial

TTO was part of exposure to correct the patella Baja

Had a delayed wound healing issues

 

12 years later walking with 0 to 70 degrees flexion. walking full wt bearing with no pain