Re-revision hip replacement in peri prosthesis shaft femur fracture in operated case of cemented total hip replacement

Abstract

Introduction: Revision surgery differs from original total hip replacement surgery, which is a lengthier and more difficult process. To get a satisfactory result, substantial preparation is required, as well as the use of specialised implants and instruments. Periprosthetic fractures are most commonly caused by a fall and frequently necessitate revision surgery. Most modifications will include the use of customised implants intended to compensate for compromised bone and soft tissue. Case Report: 68-year-old male with bilateral cemented total hip replacement presents with peri prosthetic shaft femur fracture in left side without DNVD which was van-couver type B2 managed with ORIF + Platting + TBW loop which eventually failed, impairing the patient's routine activity, so he came to SMIMER hospital. Management: We performed implant removal + revision total hip replacement with long stem femoral component, which failed post-operatively, therefore the patient underwent Re-revision surgery with inter locking nail femoral long stem component. During repeated follow-ups, the patient expressed satisfaction with his everyday activities. Discussion: Complication are common in revision surgery. Early management is key to rectify intra operative and post-operative complication. Periprosthetic femoral fractures after total hip replacement is a rare but feared complication. Peri prosthetic fracture is managed based on fracture pattern and stem and bone stock. Conclusion: Surgical treatment of periprosthetic fractures, thanks to the introduction of new implants for osteosynthesis and development of new stems for revision endoprostheses, helps achieve ever better results. Of major importance for choosing the treatment method is correct classification of fracture and stem stability.