Short Stem Hip Replacement Review

Short Stem Hip Replacement

Short Stem Hip Replacement review @2 years. It shows preservation of bone. It is ideal for young and middle aged patients needing a Hip replacement in India. Visit for more information.

Short Stem Hip Replacement

Short Stem Hip Replacement

Avascular necrosis Hip Treatment India

Avascular necrosis Hip

Avascular necrosis Hip

Do you suffer from Avascular necrosis hip in India? It is a common condition among young patients. Common causes include steroid intake, alcohol overuse, trauma besides others.
It needs prompt diagnosis and treatment.
Non operative methods fail in 80% cases. Surgery is invariably required. We offer Core decompression and stem cell treatment for early stages. In late cases with arthritis, I do short stem hip replacements. This presentation explains the complete range of treatment offered in my clinic. The treatment provided are
Core decompression.
Core decompression + Stem cell treatment.
Short stem hip replacement.
Total hip replacement.
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Avascular necrosis hip replacement

Neck preserving hip replacement in Avascular necrosis 
Avascular necrosis hip replacement of femoral head often leads to hip replacement. With the decline in popularity of hip resurfacing, neck preserving hip replacement is emerging as the treatment of choice. This procedure is advantageous in young patients. These are-

Neck preserving Hip replacement

Neck preserving hip replacement

  • Primary tri planar stability
  • Fixation in neck cortex
  • Physiological stress distribution
  • Elasticity of the bone prosthesis system
  • Bone stock preservation
  • Simpler revision to total hip replacement instead of revision hip replacement.

See how a short stem hip replacement is performed by Dr.A.K.Venkatachalam. Visit

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Acetabular fracture treatment in India-short stem hip.

Acetabular fracture treatment in India

Malunited acetabular fractures- Role of short stem hip replacement by Dr.A.K.Venkatachalam

See here for more information about treatment of acetabular fractures.

Hip resurfacing failure

Hip resurfacing failure with loose socket

 Hip resurfacing failure – treatment with short stem hip replacement. See our website, for more information. Short stem hip replacements preserve bone in the neck of femur allowing a revision hip replacement later on. Short stem hip replacements are thus a valuable option for failed hip resurfacing.

Hip Resurfacing revision with short stem hip replacement in India

Neck sparing hip arthroplasty as an option for hip resurfacing failure

Hip resurfacing revision is often required as hip resurfacing has an early failure rate of 10%. There is bone and soft tissue destruction. However most patients who underwent hip resurfacing  are young or middle aged. Recommending a total hip arthroplasty may be too drastic for them. In this scenario, short stem hip replacement or neck sparing arthroplasty offers an interim solution. It can postpone a total hip replacement by several years. However it will have to be done fairly early before tissue destruction is advanced.

Short stem hip replacements with the Proxima hip have been performed in the last decade with good success rate. This prosthesis spares natural bone in the neck of femur. The other advantage is that there is no thigh pain. It can be used with different bearings like ceramic, metal, poly ethylene. See how short stem hip replacement benefited an American patient here.

Hip resurfacing revision

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Mini hip replacement in India- better option in young patients

A mini hip replacement may be a better option in young patients. Hip arthritis in young can be primary or secondary to other disorders. A mini hip implant as shown here saves precious bone and can last for twenty years. It is a better option vs the failed metal on metal total hip replacement and Hip resurfacing ASR.

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Visit to check out more details about the types of hip replacement.

Avascular necrosis treatment India

Avascular necrosis is the most common cause of hip pain in the young and middle aged population. The most common reason is idiopathic or unknown. Other causes include steroid intake, blood disorders, fractures of the neck of femur, alcoholism.
The disease is very common in the age group 20 to 50.
Treatment options are
1) Non surgical- This has a poor rate of cure.
2) Surgical- Surgical treatments can be further divided into joint replacement or non joint replacement. Non joint replacement measures are core decompression and regenerative therapy with bone forming stem cells. This modality of treatment is relatively new and is available in India at a modest cost.
Joint Replacement- This consists of hip resurfacing, BHR, Birmingham mid head resection (BMHR),Short stem hip replacements, Birmingham mid head resection and total hip replacement with an uncemented or cementless prosthesis.
The bearings used need to be long lasting and devoid of side effects. Metal on metal bearings are used in Hip resurfacing and BMHR.
Ceramic on ceramic or ceramic on metal or ceramic on poly bearings can be used with short stem and total hip replacements. Ceramic on ceramic bearings result in the least amount of wear. Metal bearings can produce some amount of wear particles.
Most procedures mentioned above are bone preserving operations with the exception of a total hip replacement.
We have been performing short stem hip replacements with the Proxima hip since the last 5 years.

Hip replacement surgery in young patients

Short stem hip replacement

METHA hip A short stem hip with modularity

More & more young & active patients world wide are in need of hip replacement surgery. In such cases, it is imperative to pay special attention to the technique to ensure a successful outcome & longevity of the operation. Traditionally a total hip replacement was performed in the older age group. Young patients with hip pain either had to endure pain or subject themselves to a total hip replacement with its inherent disadvantages of dislocation and life span of 10 to 15 years.

Now, recent advances in bio- materials and techniques have made it possible for young patients to get a satisfactory & successful outcome after a hip arthroplasty. Definition of a young patient- The deciding factor is not necessarily the patient’s age, but their activity level. Even many older patients like to play Tennis, Golf or participate in physical activity. This applies also to anyone who can be expected to live for a long time, is biologically (not chronologically) young and has good bone quality. Today even septuagenarians meet these pre requisites. Surgeons have to re think their conventional strategy of putting in a total hip with a metal on poly bearing. Resurfacing also poses several un answered questions and cannot be considered as a panacea. Causes leading to hip pain in young patients-

Avascular necrosis is the leading cause leading to hip arthritis followed by developmental dysplasia of the hip. Perthes disease, slipped upper femoral epiphyses, sickle cell disease and post traumatic arthritis are other causes leading to the common outcome of secondary osteo-arthritis. In middle and older Caucasian patients, Primary osteoarthritis is the commonest cause of hip pain. Limitations of hip resurfacing Off late, hip resurfacing has been vigorously promoted on the internet as a possible & preferred treatment. However there are some inherent un answered problems with hip resurfacing. Elevated metal ion levels, metal allergy, metallosis are some of the side effects of metal on metal hip resurfacing. The long term impact of raised metal ion levels is unknown. Females in all age groups are high risk candidates because of the risk of fertility curbs in young & femoral neck fracture in the older. However the attraction of a hip resurfacing drives many females to ignore these risks and choose a hip resurfacing. Dr.Venkatchalam of discusses an alternate bone sparing safe approach in young & active patients. These approaches combine the advantages of a hip resurfacing and total hip replacement. Why do you prefer the short stem?

The various short stem prostheses like the Proxima hip & METHA combine the

Proxima hip

Proxima hip, A short stem mini hip implant

advantages of resurfacing & THR. On the acetabular side a full range of options is available to the surgeon. The force transfer in the femur is more proximal and more biological. Lack of a distal stem component eliminates the incidence of thigh pain. In addition these implants open up the vast range of bio materials available. All biomaterial combinations like metal on metal, metal on poly, ceramic on poly, ceramic on ceramic are possible. These promise excellent longevity. If a revision becomes necessary, then one can switch to a standard stem. Some of these models like the METHA hip make it possible for the surgeon to tailor the implant to the individual’s anatomy. What other innovations can you use to ensure a proper implant positioning? Navigation allows the surgeon to place the implant in the optimal position.

What are the special considerations in Asian patients? Dysplasia, Ankylosing spondylitis and osteo necrosis constitute the most common indications for total hip replacement in India & Asia. Primary osteo-arthritis is rare. Moreover these patients are younger and more active. Their social and religious habits such as sitting with crossed legs dictate to the surgeon that he must use a prosthesis which provides a large range of movement. Risk of dislocation has to be reduced. Anatomic differences also exist. All these variables require a special implant concept and very wear resistant materials with a large diameter. To summarize, treatment of hip arthritis in the young poses a challenge to surgeons and scientists. Hip resurfacing while offering a possible solution has some draw backs. Short stem prostheses with newer bio materials promise to overcome these deficiencies and offer a long lasting surgical outcome.

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Avascular necrosis treatment with stem cells in India

Avascular necrosis of the hip Stem cell cure for bone problemsis a frequently seen condition in young patients. It is of diverse origin and its treatment is controversial. Surgical treatment remains the key stone in late cases with hip replacement as the proved and tested method. Surgeons at the Madras Joint replacement center are proud to announce a novel form of biological treatment with stem cells. It can be performed for patients with the early stages of the disease.
When the disease is detected early by MRI scans, it is possible in India now to perform a biological treatment.

In fact a biological treatment option of early disease is a medical necessity and must be the treatment of choice whenever possible.

A novel approach to this condition is being mooted by a leading Orthopedic surgeon in Chennai, India. This is by means of stem cells. Stem cells have the potential to regenerate any tissue. In this case, bone forming stem cells are utilized to synthesize new bone over the dead bone. Stem cells are harvested from the pelvis of the patient.

There are two techniques being promoted. One is a three stage procedure and the other is a single stage procedure. Both procedures are done in India, implying that you will save thousands of dollars in treatment costs.

The first method is by stem cell culture in the lab to multiply the number of cells several million fold. These cultured stem cells are reinjected into a previous core decompression site.

In the second method, bone marrow obtained from the pelvis is centrifuged in the operating room to yield a Bone marrow concentrate rich in stem cells. These are injected into a core decompression site.

A paper presented at the recent American academy of surgeons meet in New Orleans highlighted the success story of stem cells.

To know more about the stem cell option and to determine whether your case is suitable for this unique form of treatment, send an e mail to

Dr.A.K.Venkatachalam at


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