The patient with dwarfism measures 4’3″ and suffered early onset arthritis and dysplasia of the hip bone, restricting him from movement and curtailing his normal life
With the hip bone too small, doctors at Indraprastha Apollo Hospital implanted the rarely used smallest hip cup implant in the patient
New Delhi, 5th Oct 2015: For almost 10 years, Deep Pradhan suffered from the effects of a rare disorder called hip dysplasia or misalignment of the hip joint associated with dwarfism. However, when the pain and restriction became impossible to bear two months back, the electrical engineer from Gangtok decided to travel to Delhi for treatment.
At 4’3″ of height, Deep Pradhan suffers from dwarfism, a condition that made him susceptible to this disorder. The young man suffered early onset arthritis and dysplasia of the hip joint, and increasingly found it difficult to walk, and perform other daily activities of life.
Dr Rajeev K Sharma, Senior Consultant, Orthopedic and Joint Replacement Surgeon at Indraprastha Apollo Hospital examined the patient and analyzed the challenges of operating him.
“Patients who have dwarfism and resultantly small statures are prone to bone disorders such as dysplasia or degenerative hip disease; they are also susceptible to arthritis that develops because of wear and tear of the hip joint. This happens because of development disorders and abnormal load distributions through the hip joint. The patient was in extreme pain and found it difficult to walk and even sit. A total hip replacement was the only solution in this case. However, this presented another challenge as the patient’s acetabulum or hip cup was very small,” said Dr Rajeev K Sharma.
Given the fact that the patient was a young man, only 44 years of age, it also needed to be ensured that the implant used in the procedure was good enough to last a few decades so that he may not need a revision surgery due to wear and tear of the prosthesis.
“Hip replacements are most commonly done in elderly patients who suffer fracture or displacement of bone. In older patients, implants lasting even 15 years often suffice for a lifetime. However, performing a joint replacement — hip or knee – in a much younger patient like Akash is a challenge in itself because a young patient can easily outlive the normal life of an artificial prosthesis. This is why we had to carefully choose the implant we used in the procedure,” added Dr Sharma.
The doctor used Delta motion ceramic-on-ceramic Total Hip Replacement implant by DePuy. This implant is specifically used in young patient as it has low wear rate and high longevity. The team also used a rarely used variant of prosthesis to make this surgery a success. The surgeon used the smallest available hip prosthesis – 42 mm – to achieve the best assimilation with the hip joint. Also, Dr Sharma used a special ceramic monoblock implant that has long durability and can last almost 40 years.
Within a few days of his surgery, the man was on his feet, walking without any support or pain. The patient who was suffering from immense pain before the surgery is now much relieved and hopes to get back to normal life.
“I first experienced problems with my hip joint almost 10-12 years back and underwent therapy and medication. However, 2 months back the condition deteriorated and it became extremely painful for me to walk or even lie down. This is why I decided to undergo the surgery. I am much relieved at the outcome,” says Deep Pradhan , who is set to return to Sikkim where his family is based.
He will now be able to lead a normal life without pain, discomfort or difficulty in walking