NEW DELHI: A team of doctors at Fortis Hospital, Shalimar Bagh successfully performed a rare hip replacement surgery to correct the fractured neck of the left femur of a 102-year old patient recently.
Within 48 hours of the injury, the patient was back on his feet.
The team was led by Amite Pankaj Aggarwal and Umesh Deshmukh.
The patient, Mangal Das Puri was rushed to the emergency with complaints of pain in the left hip region.
The patient expressed his inability to bear weight on left lower limb.
The patient used to walk without support before fall.
Doctors examined his condition to find out that there was a fracture on the left proximal femur (fracture neck of femur).
In view of his advanced age and the complications due to him being bed ridden, the team, after counselling and discussing with his family, made an informed decision to do a hemiarthroplasty or hemi-replacement of the hip joint.
This surgery is similar to a total hip replacement, but it involves only half portion of the hip. (Hemi means half, and arthroplasty means joint replacement.)
It replaces only the ball portion of the hip joint, not the socket portion.
In a total hip replacement, the sockets well as the ball sections are replaced.
The team of doctors from Orthopaedics, Cardiology and Anesthesiology discussed the various risk aspects and plan a recovery plan.
Given the fact that the elderly patients with hip fractures are prone to develop infections in chest and urinary tract, deep vein thrombosis, bed sores, compromised cardio-pulmonary reserve and other complications, the plan was devised.
The treatment was aimed at making the patient walk as early as possible.
After careful examination of all aspects, Puri was operated with a cemented partial hip replacement of his left hip joint.
The surgery was completed in 30 minutes.
The intra-operative and immediate post-operative period was uneventful.
Amite said, “Given the advanced age of the patient, there are many risks associated around performing a surgery. The team huddled and evaluated all the possible options before we arrived at a plan to perform Hemiarthroplasty on the patient for a quicker and safer recovery avoiding all possible risks. In order to avoid incision, a cemented partial hip replacement was carried out where the bone is cemented through a small opening. The patient responded well to the treatment as he was mobilized the next day of surgery with walker. He was allowed to bear the full weight on his operated limb.”
Umesh added, “Any surgery at such an advance age of a patient is always challenging given the numerous complications that may arise.
The patient’s poor cardiovascular status made for a challenging anesthetic management. The plan for patient’s recovery was devised factoring in all these risks. We monitored him closely throughout the surgery and the vitals were monitored and maintained for a safe surgery. Post operation, the patient responded well to the treatment and has recovered.”
It is a well-known fact that the elderly patients are most vulnerable to fractures due to osteoporosis.
However, due to advance age and other risks associated with comorbidities, such surgeries are extremely serious and require optimal clinical excellence for a safe recovery.
The hip replacement surgery may be an option if one’s hip pain interferes with daily activities and more-conservative treatments haven't helped.
In order to allow the patient to bear weight immediately a cemented partial hip replacement was carried out.
Arthritis damage is the most common reason to need hip replacement.
Conditions that can damage the hip joint, sometimes necessitating hip replacement surgery, include Osteoarthritis, Rheumatoid arthritis and Osteonecrosis.