Rare hip transplant done on 44-yr-old affected by dwarfism

A 44-year-old man affected by dwarfism has doctors at a city hospital to thank after they performed a rare procedure to implant the smallest hip cup which has enabled him to walk freely and without any pain.
For almost 10 years, Deep Pradhan suffered from the effects of a rare disorder associated with dwarfism called hip dysplasia or misalignment of the hip joint.
When the pain became impossible to bear, the electrical engineer from Gangtok in Sikkim decided to travel to Delhi for treatment.
"At 4'3" of height, Pradhan suffers from dwarfism, a condition that made him susceptible to this disorder. Patients with small stature are prone to bone disorders such as dysplasia or degenerative hip disease and arthritis. This happens because of development disorders and abnormal load distributions through the hip joint.

"Pradhan was in extreme pain and found it difficult to walk. A total hip replacement was the only solution. However, this presented another challenge as the patient's acetabulum or hip cup was very small," said Dr Rajeev K Sharma, Senior Consultant, Orthopaedic, and Joint Replacement Surgeon at Indraprastha Apollo Hospital.
Given that Pradhan was only 44-years-old, doctors wanted to ensure that the implant used for him was good enough to last a few decades to ensure he did 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 patients like Deep was a challenge in itself because a young patient can easily outlive the normal life of an artificial prosthesis.

"That is why we had to carefully choose the implant for the procedure," said Sharma.
Doctors used 'Delta motion ceramic-on-ceramic Total Hip Replacement' implant, which is specifically used for young patients as it has low wear rate and high longevity.
The smallest available hip prosthesis, of 42mm, was used for Pradhan to achieve the best assimilation with the hip joint. Also, doctors used a special ceramic monoblock implant that has long durability and can last almost 40 years.
Within a few days of his surgery, Pradhan was on his feet, walking without any support or pain.
"I am much relieved after the surgery," said Pradhan, who was operated on last week and is set to return to Sikkim.