Dr. Bose Explains Why Some People Can't Receive a Hip Resurfacing

Story provided by Vicky Marlow

Updated 10/12/08

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