Pune: A 38-year-old woman with longstanding bone problems and significant shortening of her right leg has shown improvement in mobility following complex hip reconstruction at Vencer Hospital, Pune. The procedure combined a right total hip replacement with muscle, tendon, and soft-tissue repairs to address problems extending beyond the joint itself.
The woman had a reported history of impaired bone mineralisation since birth, along with longstanding difficulties involving her right hip and lower limb. She was evaluated by orthopaedic surgeon Dr Bhushan Shitole, who identified a combination of poor bone quality, marked limb shortening and complex soft-tissue involvement.
Together, these factors made the reconstruction technically demanding. The challenge was not simply to replace the damaged hip but to establish a stable joint while addressing the surrounding structures that support movement.
The hip functions as a ball-and-socket joint, but its stability and movement also depend on the muscles, tendons and other tissues around it. When longstanding skeletal problems affect this relationship, surgical planning must consider how the implant will be supported by the bone, how the components will be positioned and how the surrounding tissues will function after reconstruction.
Limb shortening adds another consideration. Improving leg length and alignment must be balanced against hip stability and the tension placed on muscles, soft tissues, and nerves. Complete equalisation of leg length is not always possible or appropriate in every patient.
“This was not simply a matter of replacing the hip joint. We had to consider the quality of the bone, the shortening of the limb and the condition of the surrounding muscles and tendons together,” said Dr Shitole. “The aim was to reconstruct a stable, functional hip that could support better mobility, while respecting the limitations imposed by the patient’s longstanding condition.”
Following detailed clinical and radiological assessment, the woman underwent surgery on April 6, 2026. Alongside the right total hip replacement, the procedure included repair of the external rotator muscles, which help turn the hip outward, the tensor fasciae latae (TFL) tendon and other involved soft tissues.
The operation required careful implant positioning and meticulous handling of the compromised bone and surrounding tissues. The repairs were intended to support hip stability and function as part of the overall reconstruction.
According to the treating team, the patient remained clinically stable after surgery and showed improvement in hip function, mobility and overall functional status during rehabilitation.
Recovery after a reconstruction of this complexity involves more than healing the surgical wound. Rehabilitation must account for the replacement joint as well as the repaired muscles and tendon. Exercises, walking support and progression of weight-bearing are tailored to the reconstruction and the patient’s clinical progress.
The case highlights the importance of individualised treatment for younger adults with longstanding skeletal problems. For this patient, the reported improvement reflects a combination of joint reconstruction, attention to the surrounding soft tissues and postoperative rehabilitation. Longer-term follow-up will help assess how these gains are maintained.