Tuesday 4 December 2012

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 .





 

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