wrxsti280

iTrader: (6)

Bit of a strange question to ask i know, but my old man was involved in a very nasty bike accident in june last year, not his fault i hasten to add, as part of his injuries he had to have a full hip replacement, it has now transpired that the replacement is not knitting to the inside of the bone as it should do which is obviously a problem, just wanted some idea on the prognosis of such a problem, is it a case of doing another hip op or something not quite so nice like amputation??

Any help appreciated

TelBoy

My uncle did, yes. Massive infection, had to have a temporary joint put in until he could be booked in to have it done again. Not great when you're 80-odd. I'd be highly surprised if amputation was on the cards, but of course the specialists involved with your Dad's treatment will be the best source of information and advice. I wish him the best.

wrxsti280

iTrader: (6)

Right ok, he has an appointment booked to see his surgeon on tuesday as an emergency appt, but as you can imagine he has concerns over the next course of action, the reason for the op in the first place was the top of his femur dying due to poor ciculation following his accident, it now looks as thou the rest of the bone that is left is doing the same and receding away from the prosthesis

Midlife......

iTrader: (2)

How old is your dad ? It usually has a major influence on what they do ..

Shaun

wrxsti280

iTrader: (6)

69 in november, was as fit as a fiddle before accident, but a complete physical and mental wreck now, and filled with worry about what happens next

Midlife......

iTrader: (2)

Relatively (and biologically) young then . Avascular necrosis from neck of femur fractures do happen and is a recognised complication.

Surgeons usually err on the side of a caution when doing hip ops / replacements as they try and preserve the maximum amount of bone for support as it's better than replacing it with metal. Sometimes the bone continues to necrose and they have to revise the hip with a larger prosthesis (usually).

For example a well known cycle rider here in carlisle had a major off and suffered multiple injuries including a fractured hip. He had conservative surgery, the remaining bone lost it's blood supply and had to fly to Sunderland for a major total hip replacement....he's now back peddling his bike.

Everybody is an individual but mobilility and function is usually number one priority..

Shaun

wrxsti280

iTrader: (6)

Ahh right, so as it stands at the moment he hasnt had what i understand to be a full hip replacement as the prosthesis is attached to what is left of his femur?? Sorry im no surgeon so im a bit thick when it comes to trying to understand these things, so basically as i understand things, the next step would be to remove themfemur altogether and replace with a full prosthesis which replaces it??

Dingdongler

Sounds like he probably had a hemi arthroplasty which hasn't quite worked.

Next stage is probably a total hip replacement. It's not a minor op but most people bounce back from it and go on to live a normal life.

Only seen an amputation of the hip about twice in my entire life so very very rare. It doesn't apply to your dad so reassure him about that

wrxsti280

iTrader: (6)

Thanks for that, am i understanding this properly in as much as what you have suggested is the next step, is the removal of the full femur??

I,ll let him know your input which hopefully will reassure him.

Midlife......

iTrader: (2)

I think Dingdongler is more of a surgeon than me LOL

However, my hip claim to fame is meeting the *real* Mr Charnley of hip replacement fame when I worked in Manchester

http://www.hipkneeclinic.com/article...e=27&section=6

Shaun

what would scooby do

Yeah they replaced it with a Pikey

SCOOBYOLS46

mate shut up yeh if ur dad was in this situtation then you wouldn't be making jokes about it would u so shut it yeh have some respect !!!

Jamie

Have you just got out of dale farm?

what would scooby do

In English ?

wrxsti280

iTrader: (6)

Cheers fella, there is always one idiot who doesnt know when to keep quiet isnt there!!

I,ll ignore the people who have nothing constructive to offer.

The charnley link is useful, ive joined a forum based around problematic hip injuries and the wrightington hospital in wigan has already been mentioned as a centre of excellence in this field, so im going to see what comes of his emergency appointment on tuesday and take things from there.

Leslie

When I fell off the roof some years ago,the ball joint was broken off the femur so they had to install a steel ball joint which fitted the original socket. Apart from the permanent injuries to the hip and thigh muscles which will never heal, I have had no trouble with the actual hip joint so far.

I was told it takes a force equal to 40 X your body weight to break that ball joint off so it is no wonder that the muscles were stretched and damaged permanently when the joint broke.

Maybe a full hip replacement might do the trick,I wish him good luck with it all.

Les

Dingdongler

No.

This is never ever done in your situation. If you remove the femur there is nothing left for you to walk with!

Basically at the moment just the 'head' on your dad's femur was chopped off and a new head stuck on (the head looks like a ball)

One of two things has happened

1) This head has become loose

2) The head sits and then moves in a socket. Just like a domestic ball and joint socket! This socket is in your pelvis. The 'ball' may not be quite the right size for the socket. If it is too small or too big it rubs the socket in the wrong way and that causes pain and inflammation.

Treatment?

=Total hip replacement =

1) Remove that artificial ball head and replace with a new one. Just the head is replaced, your femur is NOT removed

2) Also replace the socket in the pelvis so that the ball and socket are perfectly matched.

Op duration? approx 2 hours

Hospital stay? approx 3-5 days

My fee? Not enough!

GlesgaKiss

I didn't know you were a surgeon, Ding, quite impressive. A guy they called JFK worked on my mum's legs after her accident. Have you heard of him? Was supposed to be quite an expert in the UK. Did a really good job for her in what were quite frustrating circumstances - fracture missed on an earlier x-ray so another op needed after the two femur pins (I think?) had been put in, then an infection after that op which necessitated a hip replacement. After that she was as good as new (almost!) and has been since!

I'm sure your dad will be fine.

Dingdongler

I'm not a surgeon Alan I'm a consultant anaesthetist. I work with a number of orthopaedic surgeons and gas patients for these sorts of ops day in and day out.

The surgeon gets about twice what I get paid for the same op (privately) hence my tongue in cheek comment about the fee

Midlife......

iTrader: (2)

And Consultant anaesthetists normally get paid more for clinics than Consultant Dental Surgeons

Shaun

wrxsti280

iTrader: (6)

Thanks for that ding, what about the fact that the bone may be dying away from the prosthesis?? Surely that will nessisitate the removal of the femur altogether to prevent this same problem happening again?? Is there such a thing as a femoral replacement op?? To replace the entire femur in this type of case?

Fat Boy

Ding will know better - but no the entire femur is never replaced - as he mentioned above. Basically they chop a longer bit off the top of the femur and insert a metal spike down inside the healthier bit of the femur - bit like cutting back rotten wood in a window frame until you get back to solid wood or in this case healthy bone. Usually it's just the head of the bone that the blood supply diminishes in. That spike has a metal ball on the top of it that fits into the socket set into the hip.

The length they have to cut back to to get to good bone might slightly compromise a further revision later in life, but given that these replacements now last a lot longer than they used to- 15 years and more is not unusual in some one of your father's age- it shouldn't be a problem for him.

Unpleasant for him but it can and no doubt will be sorted. Tell him not to worry and to think of the foxy young physios who will be laying hands on him shortly after the op

Have a look here for a simple visual explanation

http://www.orthopedicsurgerybook.com...esurfacing.php

wrxsti280

iTrader: (6)

Thanks for that fella, im no surgeon, can ya tell?? Lol