Sariful Alam was on his way to college from home at Sylhet in Bangladesh when he met with an accident. He was a final year MBBS student when the fate played this game on him in 1995. Alam had multiple injuries in the accident with fractures of two major bones, including the right arm and hip. He underwent a total hip replacement surgery for the fracture. For the next 15 years, he was doing well with his new hip. But gradually, he started feeling pain and the shortening of his right lower limb.
For the past six years, he was limping. Unable to find a solution for his condition back home, he decided to seek the help of AIIMS, Delhi. The orthopaedic surgeons in the AIIMS conducted a revision surgery using the donated bone grafts to create a new hip.
According to the professor and head of orthopaedic surgery Dr Rajesh Malhotra, AIIMS has the only cadaveric bone bank in India. The AIIMS doctors fully reconstructed the socket using the allograft from the bone bank and special artificial bone substitute filler. He adds that “Despite development in technology and metallurgy, there is no hip replacement in the world, which lasts for more than two decades. With time, the plastic inside the socket in the total hip replacement implant gets worn out and slowly, but progressively, causes loss of the bone around the hip.”
But the socket was almost missing in Alam’s case. The implant was lying in the soft tissue and there was a loss of bone in the upper part of the thigh as well. Dr Malhotra said this is how the total hip replacements did decades ago fail. He adds that there was no other option other than conducting a major revision surgery to bring him back to walk.
The Surgery took around two hours and following the surgery, he was under observation for 12 hours in high dependency unit. Alam was able to stand up with support, the next day itself and by the third day, he was able to walk.
Dr Malhotra stressed the need for early intervention in the case of replacement failure and donating the bone grafts as there are many cases involving major bone loss where artificial implants alone cannot help in surgery.
“Usually our patient goes home in a week and comes back a week later for suture removal. But as Alam was travelling from Bangladesh, he stayed over for two weeks during which he underwent intensive physiotherapy at the hospital and flew back to Dhaka on Friday,” Malhotra said.


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