Date: Sun, 14 Mar 2004 00:43:07 +0530
Subject: Thigh pain after hip hemiarthroplasty
From: tigeorge
Friends,
Presenting this case for your opinion. Elderly lady who underwent hemi hip replacement about one month back presented with thigh pain at rest. Had a respiratory infection during this visit which responded to treatment. Able to walk without pain with the help of walker. Hip movements not associated with pain. No local evidence of infection. During surgery the prosthesis stem had the occassional Indian problem of too big a stem for this patient's femur though the head size was okay.However it was succefully inserted without any fracture. Patient ambulated from second post op day. Her main complaint pain at rest in the thigh. Thanks in advance for your opinions.
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Dr. T. I.George
Head of Ortho Unit III
Little Flower Hospital
Angamaly, India
Date: Sun, 14 Mar 2004 09:04:17 +0200
From: Y. Ates
Cemented or uncemented?
Yalim Ates MD
Date: Sun, 14 Mar 2004 18:01:34 +0530
From: tigeorge It is an uncemented Austin Moore prosthesis.
tigeorge
Date: Mon, 15 Mar 2004 05:00:07 EST
From: Aobonedoc
Rule out infection. Was is a cemented or uncemented hemiarthroplasty implant?
Looks uncemented. Rule out infection. If not infected, live with for a
reasonable period of time and if not better revise to cemented implant.
Sincerely and respectively,
M. Bryan Neal, MD
Date: Mon, 15 Mar 2004 07:46:58 -0500
From: James Carr
It looks like a Thompson prosthesis, which was intended for cemented use.
Aspirate her hip, revise to cemented regular total hip stem +/- acetabular cup.
Jim Carr
Date: Mon, 15 Mar 2004 16:12:55 -0000
From: Niraj L Vora
> It looks like a Thompson prosthesis, which was intended for cemented use.
Didn't Thompson invent his prosthesis before Charnley came up with bone
cement???
Niraj L Vora
Date: Mon, 15 Mar 2004 22:43:34 +0530
From: rajesh
He did and in his original paper he attributes the stability to the shape of
the stem and the engineering,not cement !(not yet invented anyway !!)
Dr.K.R.Rajesh,MS,DipNB,FRCS,FRCS(Orth)
Date: Mon, 15 Mar 2004 12:32:11 -0500
From: James Carr
I don't know the history/sequence. I do know our training "dogma" was the
Thompson was for cemented use.
Jim Carr
Date: Mon, 15 Mar 2004 19:44:55 +0200
From: Y. Ates
I think the prostheisis is An Austin Moore type. Not a Thompson. Moore type
prosthesis is intended for cementless use but it is sometimes implanted with
cement.
Yalim Ates MD
Date: Mon, 15 Mar 2004 21:27:31 +0530
From: tigeorge
I thought I answered this querry before. It is an uncemented Austin Moore
prosthesis made by one of the leading Indian implant manufacturer.
Dr.T. I. George.
Date: Mon, 15 Mar 2004 14:57:45 -0500
From: James Carr
I stand corrected. Thanks
Jim
Date: Tue, 16 Mar 2004 07:01:55 EST
From: Aobonedoc
I also thought this looked like an Austin Moore although I have not seen one for 10 years.
Sincerely and respectively,
M. Bryan Neal, MD
Date: Tue, 16 Mar 2004 20:18:39 +0530
From: tigeorge
Out of ignorance, which is the prosthesis of choice for the elderly with
fracture neck of femur in your settings? What is your protocol for the
elderly with this problem? Hemi/ thr?
Dr.T. I. George.
Date: Wed, 17 Mar 2004 21:38:32 EST
From: Aobonedoc
I cement a bipolar and I bet almost any stemtoday will do. I use a bipolar
out of hope that it is less likley to dislocate although the data does not really
support this reason. Monopolar head would work well. I cement for immediate
fixation but a poster at last weeks academy meeting found press fit HA coated did
better than cemented in older (75 and over) osteoporotic patients. I do not plan
to change for now.
Sincerely and respectively,
M. Bryan Neal, MD
Arlington Orthopedics and Hand Surgery Specialists, Ltd.
Arlington Heights, Illinois 60005
Orthopaedic Surgeon
Prescot, UK
Consultant Orthopaedic surgeon
Lords Hospital & Cosmopolitan Hospital
Trivandrum, India.
Arlington Orthopedics and Hand Surgery Specialists, Ltd.
Arlington Heights, Illinois 60005
Arlington Orthopedics and Hand Surgery Specialists, Ltd.
Arlington Heights, Illinois 60005