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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

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