Story provided by Vicky Marlow
Dr. Bose explains why a female patient with advanced AVN was not able to receive a hip resurfacing.
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 I used a stem with an anatomical head metal on metal bearing. This will serve the patient very well.I have attached the operative photographs. Since the patient 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
Warning – Photos below are very vivid and real surgery!
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