Modular Stem Reconstruction For Femoral Deficiency In Revision Hip Replacement by Dr. Anoop Jhurani

Description

In this instructional video, Dr. Anoop Jhurani presents a comprehensive overview of the principles surrounding the revision of total hip replacement, focusing on the preparation and reconstruction techniques using a modular femoral stem. The case highlighted involves a complex situation stemming from a failed intra-trochanteric fracture that resulted in infection, necessitating a dual mobility approach due to abductor muscle deficiency and dislocation of the spacer.



Dr. Jhurani discusses the challenges faced with the separate trochanter fragment, the need for proper modular stem selection based on the bone quality, and the importance of an uncemented dual mobility cup for socket reconstruction. He outlines the surgical steps in detail, including the preparation of the acetabulum and femur, the use of allograft for contained defects, and critical considerations such as checking screw positions under radiographic guidance.



Significantly, Dr. Jhurani shares best practices like using protective wires during stem insertion, ensuring correct sizing through C-arm verification, and highlighting the modular stem's advantages in achieving fibrous unions even in compromised bone structures. The video concludes with a summary of the key principles for successful modular stem reconstruction, emphasizing careful follow-up to monitor for stem subsidence and ensuring a stable final outcome.

DOI: 10.1302/3114-240949

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