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Third hip replacement restores mobility to 80 year old in Chennai
Revision hip surgery is done for failed hip replacements in elderly
By: MJRC clinic
Mrs. Manorama, an 80 year old lady was finally able to walk again after two previous hip replacements had failed. She is delighted to have a new lease of life restored by Dr.A.K.Venkatachalam.
This lady underwent the first hip replacement 24 years ago for a hip fracture. A total hip replacement was done but left the leg shorter as the hip was cited high above the center of rotation by the surgeon.
She managed for twenty four years but this hip began to fail and she was unable to walk by the middle of 2014.
She underwent a revision hip replacement in a city hospital. But again the surgeon failed to recognize that the previous hip was positioned abnormally. He repeated the same mistake of citing the socket way above the normal centre of rotation. Additionally years of plastic wear and an erroneous revision surgery had left a gaping hole in her pelvis. The revision hip replacement thus had the twin problems of abnormal position and lack of bone support.
The result was that this elderly but highly motivated lady was bedridden for three months after the second hip operation in June 2014.
Her case was shown to many doctors in the city but all refused to salvage and suggested to the family members that the lady be confined to a wheel- chair.
This was unacceptable to her US based daughters. One of them contacted Dr. Venkatachalam, a joint replacement specialist in Chennai.
He analyzed the x rays and got additional 3 D pictures taken. His critical analysis indicated that there was gross bony deficiency in the left hemi-pelvis and the socket was mal-positioned. He was able to explain the biomechanics to the elder daughter who is a doctorate in Physics in the US.
Despite the previous two failed hip replacements, the family was convinced that the elderly lady had nothing to lose by another attempt to restore her mobility. Consent was given.
The surgeon Dr.Venkatachalam reconstructed the hip with the help of allograft bone and implants made of a special material known as Trabecular metal. This material allows ingrowth of host bone into it rapidly.
The operation was a success.
After three months of recumbency and physical therapy, this lady is able to walk again.
Re revision hip replacements are very rare in India as most patients don’t live very long after hip replacements. Even if it is required, most people are scared to get their elderly parents be operated in old age. It is also rare to find patients sufficiently motivated to undergo a heroic surgery and hectic rehabilitation process. This charming lady had the courage and confidence to do it and the result is a new lease of mobility and life.