Using the longest hip prosthesis at the present to save a patient who had a hip replacement surgery for 3rd time.

18/09/2020 07:18

Doctors at Viet Duc University Hospital have had the 3rd hip replacement surgery with the longest hip prosthesis (330mm) at the present for Mr. N.T.A (42 years old) from Cao Bang.


Usually, hip replacement is performed in middle age or older people. As for young people, it’s not largely indicated to hip replacement surgery because when young, the bone has not yet developed completely, unless the patient has a severe deformity or irreversible damage, necrosis of the cap spondylitis, ankylosing spondylitis … In the case of N.T.A, although young, the patient has had a history of hip replacement 2 times in the past: The first hip replacement surgery with the partially hip replacement at 22 years old (2000). 11 years later (2011), Mr. A felt pain, had difficulty in walking and had to change his hip for the second time with a full hip replacement at Viet Duc University Hospital.


Recently, while doing house work, Mr. A unfortunately fell down. He came to Viet Duc University Hospital, was painful, lost his hip’ function, unable to walk. On X-rays examinations, doctors found the stem of hip prosthesis was not well fixed associated with fractures of remaining femur below the stem. After a thorough consultation, doctors decided to perform the 3rd hip replacement.


Doctor checked the X-ray film before the surgery for patient

Pre-operative X ray

Picture during the surgery after taken the alignment of the previous stem.

Picture: Post-operative X-ray


Ass. Prof. Nguyen Manh Khanh, MD, PhD – Vice Director of Institute of Orthopedic and Traumatic Surgery, Chief of Upper Extremities and Sports Medicine Department said: in case of patient with a complicated medical history of complete hip replacement by a 190mm long hip prosthesis (the normal joint is 120-140mm long), the doctors have considered to offer the most beneficial surgical solution for patient, handle the position of existing hip prosthesis stem while managing the broken bones.


After a thorough diagnosis, doctors have coordinated with equipment manufacturers to use the longest artificial hip at the present: 330mm (the stem is 260mm long, replacement for superior part of the femur length is 70mm) with diameter 14-15mm max. This is the stem with the replacement length which is almost the same as a normal femoral nail in the case of a normal femoral fracture. The diameter is large enough to help fix firmly in the canal of the femur, helping to fix the broken bone. Ass. Prof. Nguyen Manh Khanh, MD, PhD shared, the surgical team cleverly fixed all the muscles attached to the femur. As the young patient had to replace the hip for a 3rd time, doctors tried not to use the cement joint because it only has a lifespan of 10-15 years, which will affect the daily life of the patient.


The surgery was successful. After surgery, the patient is stable and can be discharged after a few days.


Ass. Prof. Nguyen Manh Khanh, MD, PhD examines and guides patient after surgery


Doctor recommend that patients who have hip replacement surgery should pay attention in exercise and activities, to avoid falling, which leads to replace their hip.

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