Mr. Nam, 60 years old, has osteonecrosis of the femoral head, had a bone graft, and now the pain has returned and requires an artificial joint replacement to restore the ability to walk.
Normally, bone graft surgery is effective for about 5-10 years. “Mr. Nam’s case is quite rare, the graft was effective for nearly 20 years thanks to good treatment and compliance with exercise and scientific activities,” said M.D. Le Dinh Khoa, Head of Joint Reconstruction Department, Orthopedic Trauma Center. picture, Tam Anh General Hospital, Ho Chi Minh City, said on October 8.
Currently, X-ray results show that the disease has recurred, Mr. Nam’s hip joint has completely necrotic, no longer able to be preserved, causing sharp pain running from the groin to the knee, limiting movement. Doctor Khoa prescribed hip re-surgery for the patient using artificial joint replacement.
Doctors use TraumaCad software to measure, calculate, and select the type of joint that can be restored to closely resemble the patient’s natural anatomy. The surgical option is to use the ABMS surgical technique combined with the hip joint to preserve maximum bone. ABMS is an anterolateral incision that helps preserve all of the natural tendon and muscle groups around the hip joint. After surgery, patients have less pain, less blood loss, can move, and are discharged from the hospital sooner, avoiding complications such as dislocation, nerve damage, paralysis…
The bone-preserving artificial joint consists of two main components: the acetabulum and the femoral head. The acetabulum is made of polyethylene plastic, coated with titanium on the surface, and has elasticity similar to the patient’s bone. Thanks to that, patients feel more natural when moving and prevent bone loss around the artificial joint, helping to prolong joint life.
The femoral head of the artificial joint has a short and curved shank, suitable for the shape of the patient’s natural femoral neck, limiting bone curettage. This helps minimize bone loss. If the patient needs another joint replacement in the future, there will still be enough bone left to perform surgery.
On the first day after surgery, Mr. Nam could walk easily without assistive devices and was almost pain-free. The length of the patient’s legs is balanced, restoring an almost normal gait. After surgery, he practiced rehabilitation, and the doctor predicted a full recovery after 3 months.
Mr. Nam walked on his own on the first day after surgery. Image: Tam Anh General Hospital
Doctor Khoa said femoral head necrosis is a condition of lack of blood supply, leading to bone and cartilage necrosis. The disease causes a lot of pain in the hip joint and limits movement. If not detected early and treated properly, it can cause disability. On the contrary, if the disease is treated at an early stage, it can be well controlled and preserve hip function without surgery. In cases where the joint is too damaged to be preserved, the doctor will prescribe an artificial joint replacement.