Early fractures after hip replacement

Early fractures after hip replacement

At a recent meeting in Chicago, with orthopedic surgeons interested in hip replacement surgery, it was discussed there has been an increase in the number of unrecognized postoperative proximal femur fractures (thigh bone) in patients undergoing hip replacement. The cause of this is multifactorial including the use of smaller incisions which sometimes can obscure the surgeon’s view of the top part of the thigh bone when inserting the femoral component, the trend towards immediate weightbearing and discarding crutches and canes early on after hip replacement and higher activity levels in the early postoperative course of patients. If a small crack occurs at the  time of initial surgery and this is unrecognized and the patient begins immediate weightbearing with minimal use of crutches or a cane, small cracks can extend into a larger displaced fracture leading to the loosening of the implant and need for further surgery. It is important for surgeons to visualize the top part of the thigh bone when inserting an uncemented femoral component to ensure that no small crack has occurred. It is important for patients and surgeons to work together to speed recovery and avoid unnecessary problems after surgery. In well fixed total hip replacements the role of crutches and or a cane is to keep the patient safe so he or she does not fall in the early postoperative period and allow for soft tissue healing and ingrowth of bone into uncemented implants.
William P. Barrett, M.D. WPB/ceb

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  1. Pat

    I was told by my surgeon that there was a very small crack in my femur, but he did not restrict my weight bearing at all. I used a walker for about 4 days and then a cane for another 4-6 days and then I was on my own. Six months later, I had my other hip done using the very same protocols. I recovered easily and am back to the fitness center with regular workouts at 5 weeks. I have no pain when walking, sitting, standing or lying down. But, I still have stiffness on each side, and when I first stand after sitting, it takes me a few minutes to get moving easily. Will this ever go away? I am 62, active, and anxious to be able to get up and go.

  2. Ed James

    Dr. B,
    I’m looking forward to my hip replacement this coming Monday (31st of March).
    The hand book that I received is informational, precise and exactly what I needed. All of the individuals that I have come in contact with have been professional in their manner, courteous and have provided good information. The seminar was short and to the point with time for questions. The room was full of patients but after the seminar there were very few questions that needed to be asked. I feel prepared and am looking forward to doing my best to support your work on the hip replacement. The only other thing I request is for each individual in surgery to tell me who their favorite teacher was in elementary school and why? After that I will be ready to go…
    Good Luck…
    Ed James