Delhi: Timely intervention saves bone tumour survivor from major hip revision surgery

New Delhi, Oct 10 (PTI) Early diagnosis and timely intervention prevented a major implant failure in a 36-year-old woman, who had once battled a rare tumour of the femur bone, as she regained mobility without undergoing a complex revision.

The patient, Sarita, was diagnosed with a giant cell tumour of the femur back in 2015 and had undergone surgery, said Dr Simon Thomas, a senior orthopaedic and joint replacement surgeon at the Max Super Speciality Hospital in Shalimar Bagh.

She initially underwent tumour excision, but subsequently required a proximal femur replacement procedure following recurrence of the condition and a subsequent pathological fracture, the doctor said.

Although this is not routinely done in all giant cell tumour cases, the decision was made to preserve function and stability after her fracture, Dr Thomas said. The procedure successfully removed the tumour and restored her ability to walk, allowing her to remain symptom-free for nearly a decade.

However, during a routine follow-up this year, doctors detected signs of the implant wearing down and early bone loss around the prosthesis.

Recognising the risk of impending implant failure, Dr Thomas and his team decided to intervene before severe complications set in.

"Usually, these prostheses last 10 to 15 years, which is why long-term follow-ups are critical," he pointed out. "In Sarita's case, we noticed early bone weakening and subtle radiological changes suggesting the implant was on the verge of failure." "Had we waited any longer, she might have required a major revision with significant bone reconstruction. Early recognition allowed us to plan a limited revision, preserve the bone, and give her a new and stable hip." The surgery involved replacing the worn femoral head with a ceramic-on-poly dual mobility implant, designed to minimise wear and tear and enhance longevity.

Intraoperative findings revealed metallosis and inflammatory changes consistent with advanced implant wear. Despite the complexity, the patient was mobilised the very next day and is now walking independently and pain-free, Dr Thomas said.

He emphasised the need for regular follow-ups for patients who undergo primary or revision joint replacement. "Detecting small issues early can prevent major revisions later," the doctor said.

Dr Divesh Gulati, the associate director of robotic joint replacement and orthopaedics at Max Super Speciality Hospital, said, "In revision surgeries following tumour-related implants, every millimetre of bone preservation matters." "Our goal was to stabilise the joint while maintaining as much native bone as possible. Strategic planning, precise implant alignment, and robotic precision together allowed us to restore balance and function without extensive reconstruction, giving the patient a durable, pain-free result," he added. PTI PLB NSD NSD