Total Femur Replacement

by Dr. J V Srinivas

Dr. JV Srinivas, the lead and senior consultant in the Department of Orthopedics at Aster RV Hospital, JP Nagar, Bangalore, recounts a complex case involving a 61-year-old female patient who presented with severe knee pain and mobility issues. The patient had a history of a road traffic accident resulting in significant spine and femur fractures four years prior.

Initially, the patient underwent spine fixation and internal fixation for the femur fractures. However, while the spine fracture healed, the left femur fracture failed to heal despite surgical interventions, leading to multiple procedures including knee replacement and subsequent revision surgeries. Complications arose with recurring infections, subsequent fractures, and ongoing challenges.

Dr. Srinivas and his team devised a meticulous two-stage plan. In the first stage, they removed infected and non-healing bone segments, followed by the insertion of a long antibiotic spacer to control the infection. After three months, the team performed the second stage, encountering the challenge of minimal viable bone for traditional replacement.

Considering the severity and lack of suitable bone for standard methods, the team opted for a rare procedure - a total femur replacement. This involved sophisticated components imported from Germany, reconstructing the entire femur from hip to knee and connecting it with a rotating hinge knee joint.

The procedure, intricate and expensive, involved surgical precision to replace the hip joint, maintain muscular attachments, and ensure a stable, articulated structure. The patient's recovery was impressive, transitioning from being bedridden to pain-free mobility after the successful procedure.

Dr. Srinivas highlights the exceptional nature of total femur replacements, especially in trauma cases, emphasizing the necessity of specialized infrastructure, surgical expertise, and support for such rare procedures. He asserts that with the right resources and skilled professionals, hospitals like Aster RV can effectively undertake and succeed in performing these complex surgeries, ultimately restoring mobility and comfort to patients.

Watch the full video for detailed insights into this remarkable and successful surgical procedure.

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