Single stage revision of peri-prosthetic hip fracture with Stanmore femoral endo-prosthesis (Stryker) and Trident constrained acetabulum (Stryker),utilising the Zimmer-Biomet Explant and Stimulan bone substitute(Biocomposites). surgical technique
Subscribe to get full access to this operation and the extensive Hip Surgery Atlas.
Learn the Single stage revision of peri-prosthetic hip fracture with Stanmore femoral endo-prosthesis (Stryker) and Trident constrained acetabulum (Stryker),utilising the Zimmer-Biomet Explant and Stimulan bone substitute(Biocomposites). surgical technique with step by step instructions on OrthOracle. Our e-learning platform contains high resolution images and a certified CME of the Single stage revision of peri-prosthetic hip fracture with Stanmore femoral endo-prosthesis (Stryker) and Trident constrained acetabulum (Stryker),utilising the Zimmer-Biomet Explant and Stimulan bone substitute(Biocomposites). surgical procedure.
Deep infection is the bane of arthroplasty surgery and when it occurs produces technical challenges to the surgeon well above and beyond those of primary arthroplasty. No matter how onerous the resulting surgical challenge it is put into appropriate context by remembering that what this represents to a previously well functioning patient is immobility, pain, loss of independence and not infrequently depression.
The hip replacement revision case detailed is that of a woman twelve years down the line from a well functioning hip arthroplasty who suffered a peri-prosthetic femoral fracture due to a fall. The subsequent internal fixation was complicated by infection with resulting migration of the femoral implant.
However despite the obvious pathological condition of the hip, the patient did not want surgery and was coping until she became septic. This warranted an emergency debridement to decrease the septic load and suppressive oral antibiotics.
Eventually symptoms of pain and difficulty mobilising became too much and the patient consented to further surgery to restore some semblance of normal mobility.
The following case documents the stages involved a single stage (dirty to clean) revision from a failed peri-prosthetic fractured hip replacement to a proximal femoral endo-prosthetic replacement (Stanmore, Stryker) and Trident constrained cup (Stryker). The surgical technique also demonstrates the use of the Zimmer Explant, a tool that allows removal of uncemented acetabular shells with very limited bone loss. The technique also demonstrates the use of Stimulan bone substitute (Biocomposites).
It is a long case and I have focused on the debridement, the kit used for the Trident captive cup and preparation of the Stimulan. For surgical details on the use of the Stanmore Proximal Femur (Stryker) please refer to Jonathan Stevensons OrthOracle technique :
This is an excellent piece of work detailing the templating, assembly and use of the implant.
Author: Mr Andrew Gordon PhD, FRCS (Tr & Orth).
Institution : The Northern General Hospital, Sheffield, UK.
- Each operation and the questions associated become a named course in the CPD section
- The operative technique itself is read as a lesson as is any company implant information if this is being assessed.
- You’ll need to tick the box to confirm this has been done and can do this immediately if you have already read the op tech.
- The vast majority of operations have a 10-15 MCQ quiz covering all aspects of the decision making and the technique
- There are four possible answers of which one is correct (or on occasion more correct) than the others.
- There are additional quiz modules on the surgical steps, the implants and problem cases being added continually
- The course is completed once all the lessons are read and quizzes submitted and passed.
- On successful completion of each quiz you will receive validated CPD points that add to the certificate in your CPD folder.
- Your dashboard also will contain a record of the time you have spent logged onto and using the site.
- The timer suspends after 5 minutes though if there is no activity.
- When you restart you will resume at the same point in the module.
- Once you have completed each quiz you will need to feedback on the module first then click “submit” and your paper will be marked.
The pass mark is 75%.
- If you fall below this level you will be directed back to re-read the slides where you’ve tripped up.
- Once these have been read you can re-do just the questions you failed on.
- Once you have passed the quiz you can return at a future stage & resit .
- Operation Quiz – 1 CPD point
- Surgical steps Quiz – 1/4 CPD point
- Implants Quiz – 1/4 CPD point
- Problem case Quiz – 1/2 CPD point
One CPD point equates to one hour of academic activity
Welcome to the Professional Development question section. The objective of taking these tests is to demonstrate that you have understood all aspects of the assessment and management of patients requiring surgical intevention. On successful completion you will receive a certificate accredited by both the Royal College of Surgeons of both England and Edinburgh as well as the British Orthopaedic Association.
Our content is designed for both Surgeons in independent practice and Surgeons in training.