January 27, 2005 marked an unfortunate day for Gaurav Sharma, who lost his mother, uncle and cousin in a car accident. He, with his family, was returning to him hometown in UP for a family function. He himself was critical in ICU.
Gaurav Sharma was mentally and physically traumatized after the incident. He went through eight surgeries in the initial years. It left him with a crutch, fused hip and short left leg.
He met Dr. Dhananjay Gupta, Director of Orthopaedics, Spine, Joint Reconstruction and Replacement Surgeon, Fortis Flt. Lt. Rajan Dhall Hospital, Vasant Kunj, Delhi (FHVK), through a relative.
Well, after consultations, Gaurav and his family decided to go for a series of surgeries again, in a hope to make him fully movable.
The surgery involved following key challenges:
- A nail was already present in his thigh bone preventing the placement of a hip prosthesis in the thigh bone. This was to be removed first through the knee joint from where it was put earlier.
- Extensively scarred tissues following the accident and multiple surgeries presented the possibility of a sound breeding ground for infection.
- The muscles around his hip joint were also scarred and atrophied because of the multiple surgeries and disuse. Due to this his prosthetic hip was unstable and more prone to dislocation.
- In youg patients, the chances of joint relaceplacements lasting for longer are quite less as wear out rate is quite high due to the activities performed in this period of life.Costly implants are needed for longer life and more surgeries to revise the worn out implants in their lifetime.
- According to nature’s law, bones that are not loaded normally, become weak and undeveloped which makes them prone to fractures and during surgery.
It was on May 5, 2016, that Gaurav underwent his first surgery at FHVK to walk again, and his final surgery was performed on September 9, 2016 and on that day he was completely able to walk without any support. And now he is undergoing physiotherapy in order to increase his muscle strength.
Dr Dhananjay Gupta shared on the case, "In the first stage, the plan was to take out the nail from the thigh bone and then open the hip joint. Implant removal is always more challenging and preferably should be done by the surgeon who had conducted it. Gaurav's case was also complicated as he already had multiple surgeries and exposure to strong antibiotics. After a month of successful Hip Replacement surgery, he started complaining of fever and a small limp."
"An ultrasound suggested a localized abscess in the muscular plane. Gaurav again underwent removal of all the implants as his infection level was high and units of blood were transfused along with specific antibiotics by CCM team to help body fight infections. Once the infection settled, patient was again taken for hip arthroplasty surgery. This time the surgery was much smoother and swifter as his hip joint was already open and there was time to plan the implants and their placement," he added.
The post-operation procedure went as planned and Gaurav was allowed full weight bearing from day one. All investigations are normal now post six months after the surgery in May 2016. He is able to walk without taking any support with a slight limp. And the slight limp is because of muscles around the hip that are still weak but he is hopeful to overcome that little hindrance.
We salute to the faith and spirit of the boy and the family to continue with the fight against all odds.
Abrar Ali Dalal, Facility Director, Fortis Flt. Lt. Rajan Dhall Hospital, Vasant Kunj, Delhi said, "This is an example of a case that was very complex and extremely moving. In the absence of a normal environment, growing bones assume an abnormal shape and size."
"The normal stress of running and jumping make the bones stronger which didn't happen in Gaurav's case. Hence there was a strong possibility of bone fracture during surgery. We had to do two rounds of surgeries, but after all post-op procedures and checks, Gaurav has resumed college and passed the exam with flying colors," he added.
The patient, Gaurav said, "I was dwelling in uncertainty before I met Dr Dhananjay Gupta. Although not comfortable with the idea of surgeries; God knows what made me trust Dr Gupta. It was a temporary shock when I had to redo my surgery after the first one last year, because of the various challenges in my case. However, when I saw myself walking without support in the mirror, I had no words to comment.