Question: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.Tad M. Mabry, MD, et al. Long-Term Results of Total Hip Arthroplasty for Femoral Neck Fracture Nonunion. In The Journal of Bone and Joint Surgery. October 2004. Vol. 86-A. No. 10. Pp. 2263-2267.
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