Houston Methodist. Leading Medicine

Hip FAQ

Question:

If only I could turn back the clock of time. I was getting off the subway in a big hurry, caught my heel on the platform edge, and fell. I broke my hip but worse than that, I have a hip replacement and the fracture was in the bone around the new hip. Fortunately just the tip of the stem is broken. I'm waiting for the surgeon now to tell me what's what. But I'm wondering what you can tell me about what to expect while I'm waiting.

Answer:

The surgeon will be looking at X-rays and other imaging studies to determine the severity of the implant damage. The surrounding bone will be examined for any fractures as well. The X-rays will show the surgeon if your implant is still in good position (or not). The films also reveal any subisdence that might be present. Subsidence is the medical term to describe when an implant like a joint replacement sinks down into the bone. Sometimes it is even possible to see if there was any pre-injury loosening that you didn't know about. There are several different surgical treatment options for a break in the tip of a femoral stem. The surgeon will decide on the best approach keeping in mind the need to maintain limb length, limb alignment, and promote fracture union. Some of the tools available for this type of injury include bone grafts, a metal plate with a special cable system, locking screws, or some combination of these choices. Clinical reports from other patients with this same type of problem suggest a healing time of 17 weeks on average. "On average" means some patients recovered faster while others took longer. General health of the patient can make a difference in healing time. Medical problems such as diabetes, heart disease, or poor circulation can create delays in healing. Poor nutrition is another risk factor for slow or delayed healing or even nonunion (failure to heal). Jason L. Gould, et al. Periprosthetic Fractures of the Femur. In Current Orthopaedic Practice. September/October 2011. Vol. 22. No. 5. Pp. 412-421.

*Disclaimer:* 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 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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