Avascular necrosis – Total Hip Replacement surgery India

A young male underwent bilateral Hip replacements for Avascular necrosis of hips by Dr.A.K.Venkatachalam. He narrates his experience here.

“I work in Saudi Arabia. I underwent a left total hip replacement for Avascular necrosis in March 2014.  I was relieved of pain and my gait improved tremendously.

I have now undergone a right total hip replacement done by Dr.A.K.Venkatachalam. I hope that I will improve in the same rapid manner.”

HR, Chennai.

 

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.

Total Hip replacement for sequelae of childhood septic arthritis hip

Septic arthritis hip

Difficult hip replacement for childhood septic arthritis hip

Septic arthritis hip sequelae – total hip replacement in India.

A young Nigerian accountant got total hip replacement in India for a chronic condition of the hip. Childhood sepsis had led to a destroyed and undeveloped hip. Total hip replacement restored mobility. An S-ROM hip replacement with Pinnacle cup was used. Hard bearings used in this case will ensure a durable outcome in this young patient.

http://tinyurl.com/qca7avo

Visit www.hipsurgery.in for more information about hip replacement, revision surgery, failed hip resurfacing surgery, core decompression, stem cells etc.

E mail drvenkat@kneeindia.com to get a risk free quotation.

Hip replacement for hip socket fractures in India

Hip replacement for hip socket fracture in India. Hip socket fractures or acetabular fractures  occur on the socket side of the hip joint. The hip joint is a ball and socket joint. The ball is formed by the upper end of the thigh bone ( femur). The socket ( acetabulum) is the receptacle at the outer side of the pelvis.

Hip replacement for hip socket fracture

Acetabular fracture

Socket fractures occur due to the following causes

  • Four wheeler accidents
  • Fall from height
  • Domestic falls in elderly
  • Direct trauma to hip joint

Open reduction and internal fixation is the best treatment in the initial stages. Improper fixation can result in hip arthritis. Patients with this condition will experience pain and will require a hip replacement.  Most patients who suffer this are young. Total hip replacement is the recommended treatment. A short stem hip replacement is an alternative to THR in these young patients. In some elderly patients, these fractures can be left to heal naturally. In the young patient,  proper treatment is mandatory to avoid hip arthritis.  The priority is to get a stable socket fixation. Acetabular fixation employs uncemented sockets, bone graft, metal augments, supplementary fixation. Once the acetabular side is sorted out, attention is given to the femoral side. Here the primary choice so far has been a total hip replacement. We have pioneered an alternative approach to the implant on the femoral side with the use of a short stem hip replacement. The main advantage of short stem hip replacement is that it conserves bone on the femoral side. The presentation shows  a series of acetabular fractures treated by Dr.Venkatachalam.

This presentation shows hip replacement in neglected acetabular fractures.  It was presented at the Indian Orthopedic association meeting in Dec 2012 in Chennai

stem hip replacement. An Indian patient describes his experience of hip replacement for acetabular fracture here. He received a short stem hip replacement for a neglected acetabular fracture. Total hip replacement in India patient story from ALAMPALLAM VENKATACHALAM on Vimeo. Discover more information about hip replacements for acetabular fractures here, www.hipsurgery.in  Dr.A.K.Venkatachalam has treated a large number of patients with acetabular fractures. You can see the presentation here http://www.slideshare.net/akvenkat/surgical-treatment-of-acetabular-fractures-at-mjrc With this experience, Dr.Venkat is able to give 100% assurance. If you have pain and need an affordable hip replacement, e mail -drvenkat@kneeindia.com

Ceramic Hip replacement | Medical tourism India

Ceramic hip components

Ceramic hip replacement

A Nigerian patient sought a hip replacement in India. He was suffering from a neglected posterior dislocation of hip with avascular necrosis. He was given an advanced Ceramic on Ceramic hip. Although the US FDA only recently accorded sanction for ceramic on metal hip replacement, this procedure had been done by us since the last two years.

 

 

 <a href="http://www.linkedtube.com/ttPCrYe40z882023487929238f5207f79f0778ece8c.htm">LinkedTube</a>

Total hip replacement in neglected acetabular fracture

Hip replacement in neglected acetabular fracture
Dr.A.K.Venkatachalam
Consultant Orthopedic surgeon, Chennai,
www.hipsurgery.in

Acetabular fractures are often sustained in four wheeler accidents. Most patients are young. The ideal treatment is internal fixation in displaced fractures. In neglected fractures or following improper fixation, avascular necrosis and secondary osteoarthritis result. In such cases total hip replacement is required. This case report shows a total hip replacement for a neglected acetabular fracture.
Case report- Mr. S A, a 30 year old Nigerian male presented with a neglected acetabular fracture of two years duration.

The head of the femur is lying posteriorly on the ischium.
He was taken up for a one stage acetabular reconstruction and a total hip replacement.
Technique
Acetabular reconstruction was achieved with a cortico cancellous bone graft from the femoral head. The posterior wall was recreated with bone graft fixed in place by a contoured reconstruction plate.
After achieving a contained acetabulum, it was prepared to receive an uncemented Pinnacle cup. This multi holed cup was fixed with four screws. A Corail stem was used on the femora side. The bearings were Ceramic on ceramic.  This case report can be seen here
E mail- drvenkat@kneeindia.com

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.

Sufferin from hip pain? Hip resurfacing a solution

People dread getting old. If you are Caucasian and approaching your forties, you may have already noticed that some of the things you did as a teenager aren’t that easy anymore. As a general rule, if you take care of yourself when you are young, getting old will be easier. Joint pains develop and progress to restrict your life style and stop you enjoying outdoor activities.

A lot of people will have to face as a part of the aging process one of those things is hip replacements for hip pain.

According to The National Institue of Arthritis and Musculoskeletal and Skin Diseases there are over 193000 hip replacements performed in the U.S. each year. In the UK, the numbers are about 5, 00000 per year.

Hip resurfacing operation

Hip resurfacing operation

Total hip Replacement in Young patients

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 www.hipsurgery.in 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

Proxima hip prosthesis

Proxima hip prosthesis

the 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

METHA hip

METHA hip

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 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.

Contact us- drvenkat@kneeindia.com

akvenkat15@hotmail.com