Complex total hip replacement surgery in a patient with protrusio acetabuli (rheumatoid arthritis) ,- bangalore , india
65 yr old , rheumatoid arthritis lady came to us on a wheel chair, not able to walk - she had a history of RA , on steroids , osteoporotic bone and diabetic pre op plan - correct shortening of 2 cms lateralize hip center build up base of acetabulum with mashed morcelized bone graft use oversized cup to get a peripheral fit with screws v. off set 54 mm and h offset 50 mm we used pinnacle uncemented cup - 180 degree coverage cup insitu fixed with two screws neutral liner UHMWHDP LINER INSITU SUMMIT UNCEMENTED STEM COCR -32 HEAD COCR HEAD INSITU HEAD MATED TO SUMMIT STEM AIMS ACHIEVED- shortening 2 cms - gained cup lateralized cup 50 peripheral fit and offset targets achieved intraop in addition - iliopsoas , adductor and it band released