Total hip replacement is a commonly performed surgery in the elderly population. The challanges we expect are the patient’s age, existing medical comorbidities, explaining the potential risks and benefits of the surgery.
The centenarian who sustained a neck of femur fracture following a fall presented to our emergency department with excruciating pain and difficulty in walking. Comprehensive examination and immediate attention was given to the patient and relevant xrays were taken.
Usually a neck of femur fracture would require a surgical management irrespective of the age. Deferring the surgery may lead to non union of fracture, delayed rehabilitation and increased complications such as deep vein thrombosis, decubitus ulcer, respiratory and urinary tract infection, increased morbidity and mortality.
However with his age, analysing the existing comorbidities and potential postoperative complications a collective multidisciplinary decision is warranted. Explaining the high risk to the patient and his attenders, a total hip replacement was performed without any complication, thanks to the expert multidisciplinary approach, which kauvery hospital is known for. Post operative rehabilitation was initiated on the first postoperative day and was mobilised with walker support.
Compared to younger patients, geriatric patients >80years after total hip replacement have and equal improvement in postoperative mobility. While rates of orthopaedic complications are comparable too, non orthopaedic complications occurs more frequently in geriatric population and is to be monitored on a regular basis in the initial stages.
Dr A. Aravind DNB PG Resident, Dept of Orthopaedics Kauvery Hospital, Chennai
Dr. Mukunth Krishnamoorthy Consultant Orthopedic Surgeon Kauvery Hospital, Chennai
Dr. P. Keerthivasan Consultant Orthopaedic Spine Surgeon Kauvery Hospital, Chennai
