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Difficult Total Hip Replacement

  • Patient by name Kishore of age 63.
  • Pain right hip and unable to weight bear since 1 year came to ortho opd.
  •  h/o injury 10 years ago treated with hemiarthroplasty and immediate dislocation of right hip postoperatively in 3days.



  • The patient has not visited the hospital again and decided to take rest and started weight-bearing in a few days with short limb gait.
  • X-ray was taken and found dislocation of right hip high up to iliac crest with Austin Moore prosthesis in situ.
  • He was advised total hip replacement with special dual mobility hip implants.
  • Dual mobility hip implants have very less chances of dislocation.
  • Patient in a lateral position
  • Watson & jones anterolateral incision was given instead of previous posterior incision
  • AMP was extracted
  • The acetabulum was prepared and cemented dual mobility acetabular cup was inserted.


  • Since the proximal femur migrated high up to the iliac crest, shortening of the femur with subtrochanteric osteotomy was done and both parts brought together and fixed with 4.5mm Dcp plate.

  • A femur was prepared with sequential reaming and trail implants were used to check sizes and stability and uncemented solution stem was inserted and reduced.

Dr K J Reddy, MS (PGI) DNB, FRCS (Eng) FRCS (Ed). FRCS (Ortho UK) Consultant Orthopaedic Surgeon, Apollo Hospitals, Jubilee Hills

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