Total Hip Replacement for AVN with Fibular Graft and Stuck Screws by Dr. Anoop Jhurani

Description

In this instructional medical video, Dr. Anoop Jhurani discusses a complex case involving a 40-year-old patient with a previous fractured neck of the femur and avascular necrosis (AVN). The patient had undergone an avascular pedicled graft using fibula around 12 years ago. Dr. Jhurani elaborates on the challenges faced during the revision surgery, particularly the removal of screws inserted from anterior to posterior that are now embedded in dense, sclerotic bone due to previous surgical interventions.



The video details the surgical approach chosen—posterior access—which complicates the retrieval of the screws. Utilizing a high-speed Midas tool, Dr. Jhurani demonstrates the careful removal of sclerotic bone, ensuring minimal disruption to the proximal femur to maintain structural integrity for the insertion of a primary stem prosthesis. He emphasizes the necessity for finesse in surgery to avoid excessive bone loss while addressing difficult cases that may complicate revision surgery.



Throughout the procedure, Dr. Jhurani provides insights into selecting a longer stem type for better stability in cases of proximal bone disruption while underscoring the importance of proper technique and experience in navigating unforeseen surgical challenges. The educational content culminates with a successful outcome reflected in postoperative X-rays, reinforcing the video's central teaching on managing complex orthopedic cases.

DOI: 10.1302/3114-230033

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