This section details the clinical management of Revision Hip Arthroplasty—the surgical salvage and reconstruction required when a primary hip replacement fails due to osteolysis, infection, or catastrophic bone loss.
We manage revision hip arthroplasty as a sophisticated engineering solution to prosthetic failure. Under the clinical direction of Dr. Saminathan Suresh Nathan, we specialize in the management of osteolysis, implant loosening, and recurrent instability. Leveraging our deep background in oncological limb salvage, we are uniquely equipped to handle massive acetabular and femoral bone loss using specialized revision stems, trabecular metal augments, and custom-engineered reconstructive solutions.
The Pathology of Failure Primary hip replacements fail through three primary mechanical and biological modes: Aseptic Loosening (implant-bone interface failure), Periprosthetic Infection, and Instability (recurrent dislocation). We treat revision surgery not as a "part replacement," but as a structural reconstruction of the pelvic and femoral geometry.
The "Must-Not-Fail" Objective Drawing from our background in oncological limb salvage, we apply the same "over-engineering" principles to revision surgery. When the native bone stock is destroyed by metal debris or infection, we utilize revision-grade materials—trabecular metal, modular tapered stems, and structural allografts—to restore weight-bearing stability.
Technical Strategies for Reconstruction
Acetabular Defect Management: Utilizing "cup-and-cage" constructs and trabecular metal augments to restore the anatomical center of rotation when the pelvis is compromised.
Extended Trochanteric Osteotomy (ETO): Performing controlled surgical splits of the femur to safely extract well-fixed components while preserving the muscular attachments of the gluteus medius.
Distal Fixation: Utilizing modular, fluted titanium stems to bypass proximal bone loss and achieve stable fixation in the distal femoral diaphysis.