The Story

“Liam is a 50-year old gentleman who presented with a complex orthopaedic history. As a young teenager, he suffered a slipped upper femoral epiphysis (SUFE) which required operative intervention. He underwent pinning and an osteotomy to try and repair the growth plate of the right hip. Unfortunately, as a result, he was left with a leg length discrepancy and a very stiff hip joint. This got to the point where it was reducing his mobility so we decided to intervene.”

To be checked by PROF


The Investigation

To be completed by ROB


The Evidence

this shows severe deformity of the right hip, with pins in the right femur from previous surgery.

Anteroposterior plain radiograph demonstrating a severe deformity of the right hip, with pins in the right femur from previous surgery to repair his previous slipped upper femoral epiphysis.

 

Anteroposterior long leg radiograph which is used to determine the source of the leg length discrepancy and plan the surgery. Newer imaging methods such as EOS are now available.


The Diagnosis

Liam was diagnosed with a severe right femoral deformity leading to a stiff right hip joints and a leg length discrepancy.


The Plan

To be completed by PROF

 

Long stem corail used in revision for Paprosky Type 2 & 3A defects, or primary for osteoporotic bone, or very large femurs.

 

The Operation

To be completed by ROB


The Outcome

Anteroposterior plain radiograph taken immediately after the procedure demonstrating satisfactory positioning of the long stem Corail implant.

Anteroposterior plain radiograph taken one-year after Liam’s procedure. It shows that the implant hasn't moved since the post-operative image was taken.

Liam made a very good recovery. He is now able to mobilise without pain and he is very happy with the overall result.


The Verdict

“The use of a long non-modular femoral stem allows the surgeon to bypass femoral defects. This helps to gain femoral stability in more complicated femurs. The use of long leg radiographs can help in determining the source of a leg length discrepancy but now we opt to use EOS scanning. This method uses low dose x-ray radiation to take orthogonal images of patients in functional positions (standing and sitting). Not only can this help to understand a leg length discrepancy, but it can account for pelvic tilt.”

To be checked by PROF


In Closer Detail

  • Needed


Evidence for this treatment

  • Needed


Related Cases…

  • Needed