THR

7. No flexion or extension. Patient uses his pelvis and lumbar spine in order to achieve any
movement around the pelvic area. Patient had no abduction, adduction, internal or
external rotation of the hips.

9. X-ray : Pre-operative anteroposterior radiographs of a) the pelvis, with the absence of

joint space suggestive of fibrous ankylosis. No fractures or dislocations, no sclerosis,
no lytic areas were reported

10. Definition : THR is a total hip replacement consisting of a femoral head and femoral neck
. this is the ideal treatment for ankylosing hip. Because Using current implant design and
techniques, the implant survival at 20 years is favorable, with over 90% implant survival
in multiple studies.

Advantages
• Predictable immediate pain relief and return to function.
• Predictable long-term implant survival.
• Low risks and few complications for healthy patients.
• Contemporary bearing surfaces that may reduce long-term wear.
• Multiple indications (osteoarthritis,inflammatory arthritis, osteonecrosis, posttraumatic hip
conditions).
• Bone preservation options (hip resurfacing, tapered femoral stems).
Disadvantages
• Prosthetic joint replacement limitations.
• Activity limitations (nonimpact only).
• Bearing surface wear in younger active patients.
• Revision surgery complications (three to five times higher than for primary THR).
• Major complications (infrequent).
11. Material and method : Cementless titanium acetabular component. (A) The porous outer
surface permits bone ingrowth and the cluster holes allow for adjunctive screw fixation.
(B) The polished inner surface with circumferential locking mechanism accommodates a
modular acetabular bearing surface. The modular acetabular liners available for this
component include: (C) Cross-linked polyethylene. (D) Ceramic. (E) Metal.
12. Cemented femoral component. (A) Spectron EF component. (B) Postoperative
radiograph showing cemented femoral stem combined with a cementless acetabular
component, cross-linked polyethylene modular liner, and cobaltchrome modular femoral
head

13. Procedure : Common surgical exposures. (A) Anterolateral incision. This incision is
centred longitudinally over the greater trochanter and permits an abductor-splitting
approach. (B)Posterolateral incision. This approach is similar distally to the anterolateral,
curving from the tip of the greater trochanter slightly posteriorly, entering the hip
posterior to the abductor musculature.
 RAO

14. Definition : Excision of the femoral head and neck is an excellent method of relieving
pain, regardless of the cause and it corrects deformities and restores free movements of
the hip. Disadvantage :

15. Procedure : Surgery was performed with the patient in supine position, under epidural or
spinal anaesthesia using the Watson-Jones lateral approach, excision of the femoral head
and neck and a pelvic support osteotomy were carried out as a single procedure. The
osteotomy was carried out below the lesser trochanter at the level of the ischial
tuberosity. Following excision of the femoral head and neck, a tongue of bone was
outlined with multiple drill holes on the lateral part of the distal fragment. The bone was
divided around its circumference at the base of tongue. The distal fragment was abducted
after impaction of the tongue in the proximal fragment. The osteotomy was angulated
medially beneath the acetabulum and fixed by a plate bent to the desired angle.