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    ICJR CASES: Revising a Failed Total Hip Arthroplasty

    With a well-established joint arthroplasty practice, Thomas L. Bradbury, MD, is often referred patients who require a revision procedure – which means he sees a lot of interesting and unusual cases that provide opportunities for teaching other surgeons how to manage the challenges inherent in revision total joint arthroplasty.

    That’s what he did at the recent 9th Annual ICJR South Hip & Knee Course, sharing 6 cases from his practice as the moderator of a case-based panel discussion focused on tips, tricks, and techniques for performing revision total hip arthroplasty (THA).

    Joining Dr. Bradbury at the podium for this always-popular session were 4 highly regarded surgeons who also regularly revise failed THAs: Walter B. Beaver Jr., MD; Michael P. Bolognesi, MD; Frank R. Kolisek, MD; and Bryan D. Springer, MD

    Click the image above to watch the presentation and hear what these experts had to say about the following revision THA cases:

    Case 1

    • 66-year-old female patient presenting with left hip pain
    • Past medial history significant for left THA 8 years prior and revision left THA 6 years prior
    • Past medical history also significant for osteogenesis imperfecta
    • Antalgic gait; pain and weakness with active hip range of motion

    Case 2

    • 74-year-old female patient presenting with right hip instability
    • Past medical history significant for 6 dislocations since a right THA 15 months prior
    • Healed posterior incision, normal gait, intoes slightly on the right

    Case 3

    • 60-year-old male patient presenting with right hip pain
    • Past medical history significant for revision right THA 5 years prior due to a loose acetabular component
    • Past medical history also significant for colectomy due to colon cancer
    • Leg short on physical exam; painful range of motion

    Case 4

    • 52-year-old male patient presenting with right hip pain
    • Past medical history significant for right THA 18 months prior for post-traumatic arthritis following removal of a sliding hip screw used to treat a femoral neck fracture sustained in a skiing accident
    • Healed incision, normal gait, minimal pain in range of motion

    Case 5

    • 55-year-old male patient presenting with bilateral hip pain
    • Past medical history significant for left hip resurfacing 18 months prior
    • Uses a walker; otherwise healthy

    Case 6

    • 76-year-old male presenting with right hip instability
    • Past medical history significant for prior revision due to a periprosthetic femur fracture; has experienced 4 dislocations
    • Past medical history also significant for mild dementia
    • Trendelenburg gait, 0/5 abductors

    Faculty Bios

    Walter B. Beaver Jr., MD, specializes in adult hip and knee reconstruction at the OrthoCarolina Hip & Knee Center, Charlotte, North Carolina. He is the head team physician for Hendrick Motor Sports and co-director of OrthoCarolina Motorsports. He is one of the course chairs of the ICJR South Hip & Knee Course.

    Michael P. Bolognesi, MD, is Professor of Surgery, Chief of the Adult Reconstruction Division, and Director of the Adult Reconstruction Fellowship in the Department of Orthopaedic Surgery at Duke University School of Medicine, Durham, North Carolina.

    Thomas L. Bradbury, MD, is an Associate Professor in the Department of Orthopaedics at Emory University School of Medicine. He is also affiliated with the Emory Orthopaedics and Spine Center, specializing in adult hip and knee reconstruction. He is one of the course chairs of the ICJR South Hip & Knee Course.

    Frank R. Kolisek, MD, is a board-certified orthopaedic surgeon affiliated with OrthoIndy, Greenwood, Indiana. He specializes in adult hip and knee reconstruction.

    Bryan D. Springer, MD, is Fellowship Director at OrthoCarolina Hip & Knee Center, Charlotte, North Carolina; a Professor in the Department of Orthopedic Surgery at the Atrium Musculoskeletal Institute; and Medical Director and co-founder of Operation Walk Carolinas.

    Disclosures: The faculty have no disclosures relevant to this presentation.