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Center for Hip , knee and Advanced Orthopedic Surgery- Bangalore(http://orthoone.co.in/)

MINIMALLY INVASIVE HIP FRACTURE SURGERY USING SWISS NAIL IN A 85 YEAR OLD ON PACEMAKER & RENAL FAILURE, Bangalore

 

 

85 yr old woman hypertensive , chronic renal failure, diabetic , on pacemaker( High risk for surgery) came from a town 500 kms away as  the local doctor referred her to us  for the treatment of the badly comminuted trochanteric fracture

 

 

 

 

 

 

we used a Swiss Titanium / Proximal femoral nail/ PFNA  - 17 cms , Incision- 2 cms

Surgery time 35 min

Blood loss 30- 40 ml

Anaesthetic team involved a cardiac anaesthetist and a regular one

pacemaker( set to 74 , synchronous mode) technician was in theater

no electrocautery used

Patient doing well , walking with walker by second day .

 

 

 

 

 

 

 

 

 

Intra operative photo of swiss nail

 

 

 

 

post operative x ray

 

THIS CASE ILLUSTRATES THE IMPORTANCE OF OUR TEAMS CAPABILITY TO HANDLE HIGH RISK CASES.

 

 



OXINIUM - HIP AND KNEE REPLACEMENTS - REVOLUTIONARY NEW BEARING SURFACES

 

 

 

 

 

Advantages of Oxinium Bearing (30 YEAR HIP/KNEE)  for Hip and Knee replacement surgery-

 

 

 

 

1. very low incidence of allergy-low nickel  content(very biocompatable)

2.very low wear and friction rates- as in ceramic

3. 4900 times more resistant to scratching than cobalt chrome

4. no brittle fractures as seen with ceramics

5. 20% lighter  than co-cr

6.less poly wear compared to co-cr

7. no chipping , squeaking or fractures as seen with ceramics.

 

 

 

 

in short it combines the advantages of both co-cr and ceramics obviating the disadvantages of both .

 CONTACT US ON +919448444746 FOR OXINIUM HIP AND KNEE REPLACEMENTS

WORLD CLASS FACILITIES FOR JOINT REPLACEMENT SURGERY- THE JOURNEY TO BANGALORE , INDIA

                            1.  email us  / send all ur scanned x rays , CT and MRI films and reports
                             2. SKYPE with us for appointment and costs , VISA letter and assistance

                                    3.    ORTHO ONE , bangalore - where  u meet the doctor & appointment
                                                                      is fixed for surgery



 4. ADMISSION  TO  SINGLE ROOM - IN HOSPITAL

 5 .ENTRANCE TO OPERATION THEATER

 6.STAINLESS STEEL LAMINAR AIR FLOW OPERATION THEATER

 7.POST OPERATIVE RECOVERY AND ICU


 8. BACK TO THE ROOM AND

9. DISCHARGE

- TO HOTEL -till suture removal / physiotherapy  at hotel

10.HEAD HOME




 

TWO STAGE REVISION HIP REPLACEMENT SURGERY( smith & nephew - CEMENTED HIP REPLACEMENT FOR A FAILED INFECTED FIXATION (done elsewhere), Bangalore ,India

 

STAGE 1 - IMPLANT REMOVAL AND SPACER INSERTION

 

68 yrs  old woman presented to us with failed fixation , done elsewhere for a hip fracture (not only had it failed ,  it was infected too) presented to us with severe hip pain and raised infection parameters.

STAGE 1 - Remove the infected and cut out /failed  implant , debridement and place an antibiotic impregnated/eluting spacer(french) hip prosthesis with german antibiotic eluting  collagen sponge + antibiotic cement + intravenous antibiotic  4 weeks (culture grew e . coli ) followed by oral antibiotics 6 weeks

FRENCH ANTIBIOTIC  SPACER PROSTHESIS

 

                                          intra operating picture after prosthesis and cementing

 immediate postoperative check x ray

 

 

 

 

3 months post operative x ray

 

 

 

 

 

x ray at 3 months follow up  

(fracture united well/no infection) 

 

 

 

she is comfortable walking with walker and has no pain now  .
 

                                                                   STAGE 2
SIX MONTHS LATER -we did this after TC , DC , CRP AND CRP - NORMAL

                                                  Removed the  French spacer prosthesis

                                  used a Revision cement - containing two antibiotics

                          HIP - CEMENTED PROSTHESIS/ smith & nephew implant

 

 

 

                                      POST SURGERY  4RTH DAY - WALKING  VIDEO

 

 

                              culture - no growth . patient afebrile , comfortable and discharged .





 

SUCCESSFUL TOTAL HIP REPLACEMENT SURGERY( DEPUY - J&J)-in a high risk rare blood condition(SICKLE CELL DISEASE),Bangalore

CASE STUDY OF A SUCCESSFUL TOTAL HIP REPLACEMENT,IN A   HIGH RISK  RARE BLOOD CONDITION- SICKLE CELL DISEASE

28 year old girl with sickle cell disease HBS 73 % HBA 24%-  with bilateral avascular necrosis of hips , presented with hip
pain (L).


Sickle-cell disease (SCD), or sickle-cell anaemia (or anemia, SCA) or drepanocytosis, is an autosomal recessive genetic blood disorder with overdominance, characterized by red blood cells that assume an abnormal, rigid, sickle shape. Sickling decreases the cells' flexibility and results in a risk of various complications. The sickling occurs because of a mutation in the hemoglobin gene.





challenges for surgery and surgeon - 1. sickle crisis- during or after surgery
2.bleeding - increased risks
3. Deep venous thrombosis - higher risk
4. infection - higher risks
5. loosening - due to repetitive microinfarctions .


sickling is precipitated by  due to acidosis, dehydration and hypoxia.

surmounting the obstacles-

1.Preop -infection work up
2. Preop - MRI  to rule out any abscess/ infection source
3. Intraoperative OT temperature around 24 degrees to prevent hypothermia  precipitating a crisis
4. Intraoperative patient warmer
5. Intraoperative NAHCO3 infusion to keep blood alkaline
6. Preoperative haematologist advise
7. Preoperative hydroxyurea admininstration
8. Preoperative packed cell tranfusion - raised Hb from 9.2 to 11 +
9. Pre and post NAHCO3 administration
10. Intraoperative local antibiotic wash and antibiotic impregnated collagen sponge instilled
11. Postoperative warmer
12.Post op dvt prophylaxis
13. post op early mobilization
14 . post operative pneumatic calf compression pump and stockings.

Her preop x ray -

We performed an UNCEMENTED TOTAL HIP REPLACEMENT - METAL ON POLY MEGA HEAD  (  depuy / J & J) successfully , her post op xray

Her post op walking video 4rth day - patient comfortable. PATIENT DISCHARGED .  stair climbing by 8 day after surgery.

 

CENTER FOR HIP , KNEE AND ADVANCED ORTHOPEDIC SURGERY, Bangalore

ORTHO ONE ORTHOPEDIC & JOINT REPLACEMENT CENTER

We are an exclusive orthopedic and joint replacement center in the heart of south bangalore, providing world class orthopedic surgery options,

1.PRIMARY KNEE REPLACEMENTS
2. HIFLEX KNEE REPLACEMENT
3. GENDER KNEE REPLACEMENT
4. OXINIUM KNEE REPLACEMENT
5. REVISION KNEE REPLACEMENT
6. PRIMARY HIP REPLACEMENT
7. CERAMIC HIP REPLACEMENT
8. OXINIUM HIP REPLACEMENT
9 CEMENTED HIP REPLACEMENT
10. REVISION HIP REPLACEMENT
11 SHOULDER SURGERIES
12. GERIATRIC HIP FRACTURE SURGERIES
13. PEDIATRIC AND ADULT - COMPLEX TRAUMA SURGERIES
14. ORTHOPEDIC SURGERIES
15 ARTHROSCOPIC SURGERIES
16. ELBOW SURGERIES.

ADDRESS- ORTHO ONE ORTHOPEDIC AND JOINT REPLACEMENT CENTER
307, CITIBANK ATM LANE , 10 MAIN , 3RD BLOCK , JAYANAGAR, BANGALORE, INDIA

PH -919448444746
918022448355

www.orthoone.co.in
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