Jane Smith

DOB-XX/XX/XXXX

Hip Surgery Details:

  • 07/29/XXX - Left Total Hip Arthroplasty
  • 11/17/XXXX- Revision of Left Total Hip Replacement

DATE / PROVIDER / OCCURRENCE/TREATMENT / PDF
REF
XX/XX/2006 / XXXX Clinic
XXXX Finley, M.D. / Follow-up for Left Hipand Low Back Pain:Patient had a fall in October and she developed constant pain with radiation down the leg since then.
Impression: Osteoarthritis of left hip with posttraumatic component secondary to previous to previous slipped capitol femoral epiphysis.
Plan: Total hip replacement was planned if she did not improve with injection. / 21-22, 133
XX/XX/2008 / XXXX Medical Center
XXXX, M.D. (OrthoSurgery) / Patient underwent Left Total Hip Arthroplasty- James S. Finley, M.D.
Pre and Postoperative Diagnosis: Traumatic arthritis of left hip.
Detailed Procedure Notes:The labrum of the acetabulum was debrided back by sharp dissection and the acetabulum was progressively reamed up to a 51 diameter and a 52 acetabular cuff was impacted into the acetabulum. This seated fully and had excellent stability. / 41, 42
Implant Details:
  • DePuy ASR TM Taper Sleeve Adaptor; REF #: XXXX-XX-XXX; LOT#: 2XXXX
  • DePuy AST TM Uni Femoral Implant; REF#: 9998-XX-XXX; LOT# 2XXXXXX; Size:48
  • DePuy ASR TM Acetabular Cup; REF#: 9998-XX-XXX; LOT#: 2XXXXXX; Size:52
  • DePuy France Co rail; LOT#: 2XXXX
/ 70-71
XX/XX/2010 / XXX General Hospital / Patient presented to the triage with hip pain. The quality was acute and the severity was moderate.She fell at home onto left hip.
On examination, she had pain to left hip with range of motion. She was diagnosed as contusion to left hip. She was prescribed medications and was sent home. / 1, 3-8
XX/XX/2010 / XXX Clinic / NM Whole Body Scan showed increased activity within the region of left proximal femur which could represent prosthesis loosening. / 126
XX/XX/2010 / XXXX Clinic
Roy XXXX, M.D.
Richard XXX, M.D. (Orthopedic Surgeon) / Patient underwent Revision of Left Total Hip Replacementunder general anesthesia. - Richard XXXX, M.D.
Pre and Postoperative Diagnosis: Failed hip prosthesis.
Procedure in Detail: Once this was cleared, the hip was reduced and the femoral head was removed from the femoral component. The proximal portion of the femoral component was cleared of soft tissue circumferentially; bone overlap was removed.Then attempts were made to remove the femoral component. It was also noted that from the time the femoral component was exposed, it had some looseness in an anterior posterior plane, and to a lesser extent, medial-lateral plane. With dissection, there was found to be some synovium going into the space between the femoral component and the proximal femur. This was consistent with the findings of the bone scan. However, it was incredibly difficult to remove the stem with attempts being made using an extraction device, sequential attempts to dissect around the stem and, after an extended period and extensive attempts, the femoral component could not be removed.An osteotomy of the proximal femur was carried out, and once this was opened, it was found that thestepped portion of the component did have good bite more distal and the stem was removed. Cables were then used to go around the area of the osteotomy. At this point, sequential reaming and rasping was carried out and it was found that a long stem porous femoral component was appropriate. Attention was turned to the acetabulum and the acetabular component which had been cleared of soft tissue was removed with minimal difficulty, tapping on a femoral impactor and dislodging the acetabular component. On its removal, there was no obvious bony ingrowth whatsoever. Sequential reaming was carried out to a size 56 outer diameter. / 49, 58, 88-89
XX/XX/2010 / XXX Clinic Surgical Hospital
Richard XXXX, M.D. / Discharge Summary
Patient was followed for progressive pain in her hip. She was struck by a vehicle in a parking lot and had persistent pain since that time. Workup revealed loosening of femoral component of the hip. She was found to have had one of the recalled hips implanted, and was decided to proceed with revision of both components of hip prosthesis.She underwent revision of hip prosthesis and did well postoperatively. She had perioperative anemia and received 2 units of packed red blood cells. She was stable and was discharged to XXXX Nursing and Rehab. She had an episode of drainage of what appeared to be old hematoma with mobilization, but had stopped. She had no problems at the time of discharge. / 21, 117-119, 158, 162-164

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