A really challenging area of our practice is dealing with patients where hip replacements are loose and the pelvis has broken (fractured). This results in bone loss; the pelvis is unstable due to the fracture. This can occur as a result of long-term implant loosening, or a sudden failure of the bone (e.g. a fall).
The treatment depends on the pattern of the bone loss and break. The solution is a combination of removing the old implant, fixing the bones, and then re-implanting a new hip replacement. Sometimes this has to be performed via two surgical approaches to achieve the stability required.
This image shows a hip replacement that has gone into the pelvis. There is significant bone loss, and the implant is loose.
This required a challenging reconstruction involving 2 surgical approaches, the use of bone graft, plates and screws around the hip socket, bone augments, and a new implant. This radiograph was taken 6 months following surgery, the patient having resumed mobility.