If the bone cracks during the operation, then I fix it at that time. There are many ways to do so, and they have a wide range of applications depending on the type and location of the crack. I always have a few backup plans on hold if this occurs.
The main issue is to recognize this potential prior to the operation, and understand that no matter how much we prepare for an operation, there will always be circumstances that we could neither prepare for nor control.
Q: I had a right hip fracture repaired with screws and then the screws started coming out and would catch the tendon on the side of my leg, so the surgeon removed them. When I was finally released by the surgeon, I was told I had arthritis in that hip and I should consider a hip replacement. I am still limping around well over a year after surgery. Am I a candidate for SuperPATH hip replacement? If so, how do I begin the process of being evaluated for it?
A: Pretty much anyone who is a candidate for standard hip replacement would be a candidate for a SuperPATH procedure. I have converted many patients from a hip fracture fixation to a total hip replacement with SuperPATH. There are subtleties to the procedure that I may have to adjust/plan for given the increased difficulty of the case.
The evaluation process can be started by simply calling my office @ 602.553.3113 x6. My assistant will be in touch with you regarding obtaining necessary information and pre-operative work-up. More information can be found here, here & here.
A very general guide for all joint replacement is:
- You will continue to improve for an entire year, even if you feel 100% within weeks after surgery.
The following is highly variable, and represents a reasonable baseline. The recovery can be longer depending on the severity of the disease. Most of my patients stop their pain medication on the following schedules:
- Total hips in 1-3 weeks
- Partial knees in 1-4 weeks
- Total knees in 2-10 weeks
- Revision hip or knee replacement, too variable to comment
I usually recommend that my patients take 2 months off of work for any joint replacement. That way, you can always go back to work sooner if you feel like it. Most of my patients return to work within a few weeks.
Regarding implant longevity, the short answer is: we don’t know.
The point that I need to emphasize is that longevity of an implant is HIGHLY VARIABLE. It really depends on multiple factors. No patient is the same, activity levels vary, accidents can happen, and the modes of failure are numerous and unpredictable.
For total joint replacement, 10-15 years is an often quoted average. Individually, joint replacements can last as long as only a few weeks to 40+ years.
Revision joint replacements may also last as long, but depending on how extensive the revision is, this can also vary widely, and is less predictable than the original (known as a “primary”) joint replacement. Additionally, your joint’s function can decrease with every surgery that is done to it, mostly because of scar tissue formation. This also varies widely.
Partial knee replacements can have the same longevity, but they have a higher rate of revision than total knee replacements at 10 years by most studies.
Advantages of partial knee replacements are that they are easier & quicker to recover from, they feel more natural, and if/when they need to be revised, chances are high that the revision will recover and act more like a primary knee replacement rather than a revision knee replacement at that time. Even though a partial knee replacement may be the only surgery you need during your entire lifeitme, one way to view a partial knee replacement is that it may be a way to postpone getting a total knee replacement. To use dental terms: a partial knee is a “filling”, a total knee is a “crown”.
