Warning - Photos below are very graphic and of real surgery!

This case is a healthy 43 year old female patient with Advanced AVN, in this case a resurfacing was not possible, a large Metal on Metal Total Hip Replacement was the ideal solution for her to return to an active life and be pain free.

Vicky

WARNING: Photos are extremely graphic of real LIVE surgery

Hi Vicky,

Your friend’s surgery went well yesterday and she is pain free and comfortable.

During the surgery there was a large AVN lesion up to half of the femoral head. In spite of this we tried all the tricks in the book to do a resurfacing. The head neck junction was involved and the residual bone was chalk like and soft. These features made a resurfacing impossible. Since the head –neck junction was involved a BMHR was also not feasible . Therefore she had a stem with an anatomical head metal on metal bearing.

This will serve her very well and I have no doubt in my mind that she will be delighted with the result.

I have attached the operative photographs.

Since she had very small bone size I used the ASR components. I use the ASR for almost all Asian women due to the small bone size. I find a distinct advantage with the ASR in patients with small bone size.

With best regards,
Vijay bose
chennai

Appearance at initial dislocation

Did not meet our criteria for resurfacing

Head neck junction involved

More than half gone when using a resurfacing trial

Specimen after resection - half the head deficient

Very soft and chalky bone

Anatomical MoM head with a stem that was used