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Fortis Hospitals Puts 27 Year Old Nigerian Back on her Feet After Multiple Joint Replacement Surgery
Date:5/13/2010

p> In Rebecca's case the disease was severe to the degree that 93% of her haemoglobin was abnormal. This resulted in extreme abdomen pain and loss of blood supply to bones. Due to the lack of blood flow in her bones she developed avascular necrosis in her hip joint and right shoulder. "She came to us in a complete immobile state with a painful right hip and shoulder which were completely damaged. The sickle disease had affected her knees as well" said her surgeon Dr. Sachin Bhonsle, Consultant Orthopedic Surgeon.

"We had three major challenges before we decided to go ahead with the surgery. Firstly, control of her Sickle cell disease - Rebecca had 93% 'haemoglobin S' (HbS). Subjecting her to trauma of a major surgery like joint replacement, associated blood loss and stress would have precipitated a life threatening sickle crisis. To reduce her HbS to about 30% we had to perform an exchange transfusion. Exchange transfusions involved removing blood with HbS and replacing it with fresh blood of compatible donors. It took about five days to restore the HbS to a safe level, after which she was ready for surgery.

Secondly, there was the challenge of doing a shoulder and hip replacement at same time. Thirdly, when doing a joint replacement on very young patient it is important to perform a joint replacement surgery which would give her a long lasting and better quality of life."

After proper examination we decided to go ahead with the replacement of right hip and shoulder. A decision was taken to use an 'uncemented hip replacement' of a robust construction, which has a potential to last a lifetime. A ceramic bearing was chosen for this hip which again will never wear out.

Dr. Bhonsle used a minimally invasive approach to replace Rebecca's right hip whereby the hip joint was reached by minimal
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SOURCE Fortis Hospitals Limited
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