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Senior Health

Hip replacement gone wrong

09/02/2008

Question:

My Mom is 85 years old. You would never have known that up until recently. She has worked out her entire life and really stayed in shape. Ate well, never over did anything, maintained a beautiful figure. She has over the last few years has had some issues, but none that would be odd for an 85 year old. Her hips hurt (maybe from the miles of walking and tennis); experiences a little shortness of breath, and acid reflux on occasion. Other than that she has been tooling around town and very active. In January 2008, while wintering in Mexico, she fell, broke her hip.

1. March: Immediately had the hip replaced. 2. April: 3 weeks later she had an infection. They had to put her under to open up the incision to see how deep the infection was. Sewed her up and had her on intravenous antibiotics. 3. May: Infection was not going away, they put her under again and removed the ball at the top of the prosthetic and replaced it with some mixture of antibiotics and clay/cement. Another 6 weeks on intravenous antibiotics. Post 6 weeks, the blood tests said the infection was gone. We now were to wait and see if the infection returned. 4. July (middle): It did, within 3 weeks. Okay, so now the doctor is going to go in and remove the entire prosthetic and replace the whole thing with some handmade mixture of antibiotics and cement, which she will have to keep for minimally 6 weeks to determine of the infection, is gone. The plan was that after the 6 weeks, we wait, and if no infection comes back she would have her final operation. 5. July (end): But no......4 days after the entire thing was replaced with the prehistoric hand built concoction, it has dislocated. The doctor felt the need to immediately put her under again (not general this time) to try to manually put the device in place. He thought he moved it back in... 6. August: Ahhh but he did not...it is out again...and tonight, my mom is in another operation.

My mom is depressed, has no appetite, is atrophying, losing weight. We are seeing her shrinking.

How frequently does this happen in hip replacement surgery? We are alarmed the amount of surgeries she has had to undergo in such a short period of time - are there issues with anesthesiology and recovery. Should we care if she gets spinal w/twilight or general anesthesia? We are so very worried.

Your insight would be so very appriciated Thank You

Answer:

Thanks for asking me for opinion. I am sorry the mom is not doing well. It seems like her complications after a hip surgery are ongoing. It is unclear if there is only one orthopedic surgeon or many surgeons involved in her care. Was the initial surgery done abroad? It is not uncommon to see infections occurring sometimes which can be treated with antibiotics or a revision of the hip. I would recommend a second opinion on her hip surgery complications as a new view may help. Also, maintain good nutrition, pain relief with opioids if needed and intensive physical therapy currently as due to deconditioning her muscles may atrophy and then outcomes and her ability to walk in the future may be limited. Fall prevention measures should be in place. Hope this helps. Best wishes.

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Response by:

Arvind   Modawal, MD, MPH, MRCGP Arvind Modawal, MD, MPH, MRCGP
Professor of Family & Community Medicine, Geriatrics and Palliative Care
College of Medicine
University of Cincinnati