Is it common for a partial hip replacement to cause a hip fracture?

May 8th — admin

My mother just had a partial hip replacement. I guess it was like having a tooth capped. Just the top of her femur was replaced. She ended up with a hip fracture afterwards. Is this common?

It sounds like your mother had an operation called joint resurfacing. This type of operation has been around since the 1930s. It has come and gone based on problems afterwards and materials available. Most recently, new metals have made it possible to resurface the head of the femur (thigh bone) with good results.

Fracture (usually of the femoral neck) is the most likely complication of hip joint resurfacing. It happens in up to four per cent of the cases. Studies show fracture occurs most often in the first 100 cases done by a surgeon. Fracture rates go down as the surgeon becomes more familiar with this technique.

Causes of fracture are both patient and technique-related. Obesity, decreased bone mass, and arthritis make a difference on the patient side. Anyone with a femoral neck cyst should get a total hip replacement instead of resurfacing. Putting the implant in with too much of a tilt or twist can also result in fracture.

Women seem to have a higher risk of fracture after hip joint resurfacing. The reason for this remains unknown at this time. Short-term results of hip joint resurfacing are good to excellent. Long-term studies aren’t available yet. Total hip replacement may be needed by patient who have a fracture after resurfacing.

For more information on this subject, call The Zehr Center for Orthopaedics at 239-596-0100 or visit www.zehrcenter.com. The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of a visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.

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Is there an advantage to therapy for a broken hip?

August 29th — admin

My mother fell and broke her hip. I went on-line and found out that physical therapy can help her get back up and going faster. The doctor says in six months she’ll be just as good without the therapy. Is there an advantage to therapy?

Several studies have shown that physical therapy helps people regain function faster after hip fracture. The advantage is that with improved strength and motion, the person can return to regular daily activities sooner. This improves quality of life and psychologic function.

A post-fracture physical therapy program also helps restore balance and coordination. These skills help prevent future falls that could result in another hip fracture or other injuries.

As Benjamin Franklin once said, “An ounce of prevention is worth a pound of cure.”

For more information on this subject, call The Zehr Center for Orthopaedics at 239-596-0100 or visit www.zehrcenter.com. The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of a visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.

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After his recent broken hip surgery, should my father get a joint replacement?

June 8th — admin

Please help us make a family decision. Our 72-year old father fell six months ago and broke his hip. He had surgery to put a plate and screws in place to hold it together while it healed. The bone hasn’t healed. Should we wait another six weeks while waiting for bone healing, or should we go ahead with a joint replacement?

There are several things to think about in a case like this. First, what advice or counsel has your father’s doctor given you? Is your father osteoporotic, a smoker, or have diabetes or cancer? All these things can delay bone healing.

Replacing a broken, infected hip with an implant can be a very good idea. Your father will likely be able to get back on his feet sooner. Early and rapid mobilization can reduce other health problems like blood clots, pneumonia, and muscle weakness.

A recent study at the Mayo Clinic in Rochester, Minnesota, compared two groups of patients. One group had a hip fracture that didn’t heal. The joint was replaced. The other group of patients who received a hip replacement didn’t have a hip fracture first.

Durability of the implant was less in patients who had a hip fracture first and then a joint replacement. The rate of hip dislocation was also high (almost 10 percent) in this group. It may be best to sit down with your father and the doctor and go over all the risks and benefits before making this decision.

For more information on this subject, call The Zehr Center for Orthopaedics at 239-596-0100 or visit www.zehrcenter.com. The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of a visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.

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Will my hip replacement last the rest of my life?

June 6th — admin

Is there any reason why a total hip replacement won’t last me the rest of my life?

It depends on several things. Your age, the condition of your bones, and your activity level are all important. The reason you need the hip replacement is also a factor. The older you are, the more likely your implant will outlive you. Younger, more active patients tend to wear out the implant much faster than older, more stable patients. Brittle bones from osteoporosis makes the decision more difficult. Hip implants after a failed hip fracture also don’t last as long.

Finally, hip dislocation is common in patients who don’t follow their doctor’s directions. Certain motions and positions must be avoided in the first six weeks or the joint can dislocate.

For more information on this subject, call The Zehr Center for Orthopaedics at 239-596-0100 or visit www.zehrcenter.com. The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of a visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.

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After a broken hip, should a patient exercise?

April 27th — admin

My uncle fell and broke his hip last month. He’s been home on his own for a few weeks. We’re concerned about his safety home alone. Shouldn’t he be doing some kind of exercises for his hip or at least to stay active?

Exercise is a key ingredient to improving balance, strength, function, and overall health. A recent study from the University of South Wales showed the value of exercise up to four months after hip fracture.

They compared three groups: one group did weight-bearing exercises (WBE); one group did exercises without standing up, and a third group didn’t exercise. They found the WBE group did the best and any exercise was better than none.

A physical therapist can come to your uncle’s home and prescribe an exercise program for him. Even better, if he can come to a clinic he’ll get a chance to exercise and interact with other people of all ages. This may help motivate him to continue exercising.

For more information on this subject, call The Zehr Center for Orthopaedics at 239-596-0100 or visit www.zehrcenter.com. The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of a visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.

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What post hospital plans are needed for an elderly hip replacement patient?

April 9th — admin

Last week, my 83-year-old mother broke her hip. She is still in the hospital, and we are trying to make plans for when she gets out. How can we tell if she should return home or go to a nursing home?

There are a few ways to predict how a patient will do after surgery for hip fracture. Age, mental status, and the ability to get around before the fracture are three factors that predict outcome. In addition, patients who can get out of bed and walk 50 feet by the second day after surgery are more likely to do well at home. Those who can’t get up and walk may need extra help at home, or they may need to stay in a nursing home for a little while.

The hospital staff is available to help you make this decision. In addition to your mother’s doctor, you may want to consult nurses, physical and occupational therapists, and social workers.

For more information on this subject, call The Zehr Center for Orthopaedics at 239-596-0100 or visit www.zehrcenter.com. The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of a visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.

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A hip replacement patient must “transfer” by himself. What does this mean?

April 5th — admin

My father fell and broke his hip two days ago. The hospital staff says he can go home as soon as he can “transfer” by himself. What does this mean?

Basic transfers include moving from a lying down position to sitting up, and from sitting to standing. These movements are necessary for using the toilet. “Independent transfers” mean the person can do these movements without help of any kind. “Assisted transfers” mean the person can get up with the help of a device or person.

Assistance varies from having someone standing nearby to having one person on each side lifting and holding. Assistance may be in the form of a walker, or a vertical pole attached to the side of the bed.

After hip fracture, patients who can transfer and walk without any assistance are the most successful taking care of themselves at home. Patients who cannot transfer or walk without help may require family assistance or a short stay in a rehab center.

For more information on this subject, call The Zehr Center for Orthopaedics at 239-596-0100 or visit www.zehrcenter.com. The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of a visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.

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To repair my ACL, the surgeon used part of a tendon as a graft. Won’t that cause problems for the tendon now?

December 16th — admin

When the surgeon repaired my torn ACL he took a piece of my patellar tendon and used it as a graft. How can they do this without causing problems in that tendon now?

A very good question. First of all, only a piece of the hamstring tendon is removed. At least half or more of the tendon is left intact. The postharvest strength of the graft tendon must be strong enough for early rehab and daily activities.

If the graft doesn’t hold it usually pulls away from the bone with a little piece of bone attached. This is called bone avulsion.

Before these grafts were ever used on patients, scientists used animal and cadaver studies to test the strength of the tendons before and after grafting. This is how they know which tendons will hold up after a piece is removed for use as a graft.

They also found that ACL tensile strength decreased over 50 percent between age 20 and 50. This isn’t true of the patellar tendon. During this same time period, tensile strength of the patellar tendon doesn’t change. That makes the patellar tendon a good graft choice.

For more information on this subject, call The Zehr Center for Orthopaedics at 239-596-0100 or visit www.zehrcenter.com. The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of a visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.

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What is a cervical hip fracture?

September 14th — admin

Have you ever heard of a cervical hip fracture? What is that? I thought the cervical bones were in the neck, not in the hip.

There are many types of hip fractures, usually named for their location. A basic understanding of the hip anatomy will help visualize where the fractures occur.

The hip joint is one of the true ball-and-socket joints of the body. The hip socket is called the acetabulum. It forms a deep cup that surrounds the ball of the upper thighbone, or femoral head. The femoral head is attached to the rest of the femur by a short section of bone called the femoral neck. A bony bump on the outside of the femur just below the femoral neck is called the greater trochanter. A smaller bony bump on the femur called the lesser trochanter is located on a diagonal from the greater trochanter.

These two bumps on the femur are where some of the hip muscles attach. A cervical hip fracture refers to the fact that the break is inside the joint itself. Either the top of the femur (called a subcapital fracture) or the acetabulum (hip socket) have a break. Another term for the location of these fractures is intracapsular or cervical.

When the break affects the hip, but is not right inside the hip, the fracture is referred to as an extracapsular hip fracture. The fracture may occur in the neck of the femur (femoral neck fracture), between the two trochanters (intertrochanteric fracture), or in the main shaft of the femur just below the lesser trochanter and may extend down the shaft of the femur. This last type of hip fracture is called a subtrochanteric fracture.

For more information on this subject, call The Zehr Center for Orthopaedics at 239-596-0100 or visit www.zehrcenter.com. The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of a visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.

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Why treat osteoporosis after hip is already broken?

August 23rd — admin

I fell and broke my hip two weeks ago. I finally made it out of the hospital and home again. Now my doctor is after me to take drugs for osteoporosis. I don’t see what’s all the fuss. I already broke the hip. How is taking some medication going to change anything?

There is a mistaken belief that by the time a fracture has occurred, it’s too late to do anything about the underlying osteoporosis. Nothing could be further from the truth. Study after study has confirmed the benefit of a three-arm approach to the prevention and treatment of osteoporosis (which includes preventing a second fracture).

The first is calcium supplementation with Vitamin D. The second is exercise. Weight-bearing exercises on land (not a swimming or aquatic program) helps bone formation. When the muscles contract and their tendons pull on the bone, it has the effect of stimulating bone formation. And third is the use of anti-osteoporotic medications called bisphosphonates.

Bisphosphonates such as alendronate (Fosamax), ibandronate (Boniva), or risedronate (Actonel) help slow down how fast the bone is resorbed (destroyed). Everyday new bone cells are formed and old bone cells are resorbed or destroyed. During childhood, new bone cells are formed faster than old ones are destroyed. In the aging adult, resorption exceeds formation. Despite the number of older adults with osteoporosis and even a history of hip fracture, not very many people are taking these medications. And for those patients who do have a prescription, taking it on a regular basis is not consistent. But they have been proven effective in reducing hip fractures and the death rate associated with hip fractures in patients with osteoporosis. And since your risk of a second fracture goes up dramatically after the first one, your doctor is right in strongly urging you to take this medication. It’s important to take it as prescribed over a long period of time. Follow your doctor and pharmacist’s directions when taking this (or any) medication. Report any side effects. The drug dosage or specific drug can be changed or altered. The goal is to give you the maximum benefit with the least amount of adverse effects.

For more information on this subject, call The Zehr Center for Orthopaedics at 239-596-0100 or visit www.zehrcenter.com. The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of a visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.

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