What is the meaning of Complex Total Hip Replacement?

The definition of a ‘complex’ hip replacement, as opposed to a ‘traditional’ total hip replacement, is the presence of any of a range of issues in a patient which may cause problems in the standard procedure and need to be planned for in advance to ensure a successful outcome for the patient.

Although total hip arthroplasty is now a classic procedure that is well controlled by orthopedic surgeon, some cases remain complex. This complexity may due to some co-morbidities like:

  • obesity,
  • skin problems,
  • muscular problems,
  • neurological disease
  • bone deformities for example congenital hip dysplasia. acetabular protrusio (deep hip socket), converting an  already fused (arthrodesed) hip to total hip replacement. 

Thus a difficult hip arthroplasty is a procedure that increases functional, infectious, and neurological risks or that involves technical difficulties. This requires planning: which surgical approach should be used for the soft tissues? Which implant? How should the implant be positioned in relation to the patient’s anatomy? 

Preoperatively, careful evaluation of the gluteal muscles is mandatory and predicts final walking ability and patient satisfaction in cases where the hip is anklylosed and is now being converted to a total hip replacement. Intraoperatively, provisions must be made for the possible use of modular implants and/or bone grafts. 

Mr Kempanna has been doing complex total hip replacement for several years now and has been able to provide a good functional outcome to his valued patients.

Case example of Complex Hip Replacement

Example of a Complex Hip Replacement – Patient sustained fracture dislocation of their left hip while holidaying abroad. They presented in United Kingdom after 4 weeks of the injury. Injury was assessed, investigations were performed and patient underwent a complex hip replacement which required to reconstruct the exploded posterior wall of their socket and as it was 4 weeks old dislocation, a total hip replacement was performed. Patient did well after the surgery.

Fracture dislocation of the Left Hip
Fracture dislocation of the Left Hip
CT Scan Left Hip fracture dislocation seen from front
CT Scan Left Hip fracture dislocation seen from the front
CT Scan Left Hip fracture at the back of the socket
CT Scan Left Hip fracture at the back of the socket
Reconstruction of Left Socket and Hip Replacement
Reconstruction of the Socket with a plate and Total Hip Replacement