Patient with femoral neck fracture operated successfully for hip joint reconstruction at NSSH

In a surgery that was challenging owing to age-related complications and a complex medical history, senior citizen Mr. T.T. Pishori underwent a stable total hip joint reconstruction procedure with a femur long uncemented stem at Nanavati Super Speciality Hospital (NSSH).

Explaining the complexities of the surgery carried out on the ex-BARC staffer, Dr Pradeep Bhosale, Director, Arthritis and Total Joint Replacement Surgery, NSSH, said, “the surgery was not easy given that Mr. Pishori was 85 years old. Following a thorough evaluation of the patient’s medical history with the help of Dr Nitin Rathod, MD and anesthetist Dr Rane, we successfully operated upon him wherein we broke his upper femur bone and removed intramedullary cement. Following this, femur long total hip stem was used and his acetabular cup was replaced using a bone graft.” Following a successful convalescence and gradual wound healing, the patient was made to walk and maintain his balance with full weight bearing. With the help of Dr Sanjay Nabar, Nephrologist, NSSH, he was also able to gain control of urination. He has recovered fully and will be going home soon.

Mr. Pishori sustained a femoral neck fracture following a fall in mid-January. He was operated for hip replacement at a leading city hospital following which he developed post-surgery complications with pouring pus. He underwent three surgeries which involved the cleaning and removal of the joint, following which local antibiotics were administered to him through a cement-loaded spacer. Though the wound healed eventually, the patient had to suffer around 2 liters of blood loss. Mr. Pishori endured prolonged hospitalization in an ICU with a urinary catheter. With advancing age complexities and no definite treatment plan for hip joint reconstruction for ambulating the patient, he was discharged from the ICU and since then had been bedridden.

The case was inundated with multiple risk factors as the patient was 85 years old and had undergone several unsuccessful surgeries. With bones becoming osteoporotic and brittle at an advanced age, breaking of the femur bone through cemented prosthesis was a challenging task. Additional complications involved were severe soft tissue contracture with 90 degree external rotation deformity of leg and the challenge of reconstructing the hip after breaking the femur for the removal of intramedullary cement.