HIPS IN A SICKLER
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HIPS IN A SICKLER

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HIPS IN A SICKLER HIPS IN A SICKLER Presentation Transcript

  • T. M. O., d. o. b. 18.12.1971 - Sickle cell anhaemia
    • Left side:
    • Post-operative check X-Ray picture. Considering the short life expectancy of sicklers and their tendency to develop bone infections, an MS-30 cemented pros-thesis was chosen together with gentamycin cement. The acetabular cup was a Robert Mathys, metal-on-metal uncemented one.
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  • THE HEAD REMOVED FROM THE LEFT SIDE WAS KEPT DEEP FROZEN AND USED TO CREATE AN ACETABULR ROOF THE RIGHT SIDE * *
  • PREOPERATIVE PLAN * * Graft from the preserved head of the other side
  • AT THE OPERATION, THE FEMORAL SHAFT COULD NOT BE PULLED DISTALLY, SO THE GRAFT TO REBUILD THE ACETABULAR ROOF WAS FIXED WITH SCREWS AND A TRACTION WAS APPLIED .
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  • AFTER ONE MONTH TRACTION THE PROSTHESIS COULD BE FINALLY INSERTED ON THE RIGHT SIDE.
  • SECONDARY LOOSENING AND INFECTION AFTER AN ACCIDENT
    • 23.09.2008 (From Dr. Byakika)
    • Recently Tom presented to me with a painful right hip especially in the upper thigh area for a duration of about 5/12, after an accident. On examination there was a small purulent, discharging sinus over the upper mid thigh junction laterally and the area was quite tender. His C-Reactive protein was raised > 30.
    • The X-rays that I send to you are self explanatory, with the stem perforating the lateral cortex and showing osteoporosis. The acetabulum seems fine. The main problems are the sepsis and  a perisprosthetic fracture, with osteoporosis.
    • I consider that he would benefit from a 2 staged revision, first to remove the femoral stem, eradicate sepsis and second insertion of  a revision stem.
  • Secondary post-traumatic loosening
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