29/01/2026
Sharing 3 complex & challenging cases we tackled in the last week.
3 highly Complex cases last week . Complexity due to soft bone, delayed presentation & severity of trauma. Each case demanding planning, patient & precise technical ex*****on.
Case 1 - Total hip replacement - Ankylosed hip with protrusio, medial wall defect, pelvic dysplasia and superior migration in a young patient (Ank spond). Poor long term mobility meant soft bone & difficult anatomy. Insitu neck cut. Opted for a medialised (+ closed) cup without graft after careful reaming, achieving a peripheral rim fit thanks to intact anterior and posterior wall. Pre-op CT & templating was helpful here. Indomethacin post-op to prevent HO.
Case 2 - Total knee replacement - Severe knee arthritis with a 80 deg FFD (!) & 30 deg arc of movement.Poor mobility & resultant bone quality. This necessitated 2 mm additional femoral cut, release of patellofemoral ankylosis, medial & posterior release + PCL release. We achieved a 5 -120 deg ROM with a pck implant. Brace here for few days to prevent recurrence.
Case 3 - Open segmental tibia fracture (part of polytrauma). Thorough early debridement, 6-8 L saline wash, nailing & primary closure (+vac)
