Hip Replacement in Acetabular Fracture

A 78 year old Patient had an RTA and sustained a Hip injury. He was diagnosed as having a Central fracture dislocation (Bicolumnar Fracture). He was not operated by the treating Orthopedic Surgeon considering the Risks involved at the Age. He presented to us after 7 months with ProtrusioAcetabuli with AVN of Femoral head.

His major Complaints were:

•             Severe restriction of daily activities
•       Night pain and Rest Pain
•        Difficulty in Sitting and Getting up

Pre Op Xray

Discussing the risks involved, the Patient was asked to undergo a hip replacement to alleviate his symptoms.

CT Pelvis was done to get a better understanding of the defects.

CT 1

CT 2

CT 3

CT findings :

·         Defect in anterosuperior wall

·         Posterior wall was intact

·         Defect in anterosuperior part of head

Challenges of Surgery :

·         Defect Reconstitution

·         To get the Perfect Rim fit

·         Early mobilization considering the advanced age

·         Restoring near normal Hip Centre

Operative Pearls:

·     It was decided to use a Trabecular Metal cup and Uncemented Stem on the Femoral side Head and neck

·       The graft was Fixed with the Screws through the cup

·       Rim fit Gription Cup was placed and sufficient lateralization was achieved

Post Op Xray