Hip Replacement Surgery in Older Patients: Special Considerations and Complications
Hip replacement surgery can provide older patients with a new lease on life. It’s an opportunity to regain your lost mobility, spend time with family and enjoy your retirement. Play with your grandchildren, walk in the park, go on family days out, keep your independence, or just enjoy a round of golf – the possibilities are endless.
As with any procedure, older patients carry a greater risk of complications and problems post-surgery. Hip surgery is a commonplace and safe procedure – with a low rate of complications. However, it’s still essential to have a full understanding of the ins and outs of any special considerations and outcomes for older people.
In this guide, you’ll find:
- Understanding Hip Replacement Surgery
- Special Considerations for Older Patients
- Risks and Complications in Older Patients
Understanding Hip Replacement Surgery
Hip replacements involve a partial or complete removal of the damaged hip joint and the insertion of a prosthetic implant. Such implants are usually made of either ceramic, advanced plastics, or metal.
There are two primary types of hip replacement surgery:
- Total Hip Replacement (THR) refers to the removal of both the acetabulum (hip socket) and the femoral head (thigh bone head) and replacements with artificial components.
- Partial Hip Replacement (hemiarthroplasty) replaces only the femoral head but leaves the acetabulum intact.
The choice of procedures depends on the severity of the underlying conditions. Surgeons will use scans to assess the current level of damage, advising on the best course of action.
Common reasons for an older person to undergo hip surgery include:
- Osteoarthritis: The most prevalent reason for hip replacement in older adults. It’s a degenerative joint disease where the cartilage that cushions the bones wears away, leading to pain and stiffness.
- Rheumatoid Arthritis: An autoimmune condition causing inflammation of the joint lining, which can destroy cartilage and bone, leading to joint deformity and dysfunction.
- Hip Fractures: Older adults are at a higher risk for hip fractures due to falls. Sometimes, the best or only treatment option is a hip replacement, especially if the fracture affects the joint’s functionality.
- Osteonecrosis: Also known as avascular necrosis, this condition occurs when blood flow to the hip bone is reduced, causing the bone to die and potentially collapse.
Speak to a medical professional if you suspect you suffer from one of these conditions. They can advise if a hip replacement is a suitable course of action.
Special Considerations for Older Patients
Older patients carry additional risk compared to their younger counterparts. That means surgical teams will need to take special care throughout the procedure.
Preoperative Considerations
Preparing older patients for surgery requires a comprehensive preoperative assessment. This includes a detailed review of the patient’s medical history, physical examination, and appropriate tests to evaluate vital organ functions and identify any risk factors. Managing existing comorbidities is crucial; conditions like diabetes, heart disease, or hypertension need to be stabilised to minimise surgical risks.
A complete medical review is also necessary, as some drugs may need to be adjusted to temporarily discontinued to reduce the risk of bleeding or other complications.
Intraoperative Considerations
During the surgery, choosing the right anaesthetic is a major concern. Older patients can have an increased sensitivity to these drugs.
In addition, selecting the correct prosthesis is key to ensuring the longevity and function of the implant. Your surgeon will discuss your options prior to surgery, balancing the features of each implant against the risks of future surgeries.
Postoperative Considerations
Getting older patients moving soon after surgery is critical to an optimal recovery. Because older patients are likely to have less muscle mass on average, gaining more strength will help recovery and reduce the risk of falls. The stronger you become, the steadier on your feet you are.
Pain management should also be balanced to alleviate discomfort while minimising side effects. Some analgesics, in particular opioids, can cause confusion in older people. Close monitoring for complications is, therefore, a major aspect of ensuring a successful recovery and maximising long-term outcomes.
Risks and Complications in Older Patients
As mentioned, the older we get, the greater the risk surgery poses. Your surgeon will evaluate your health status to determine if it’s safe to undergo the operation. But what potential risks and complications could occur? Here’s a brief overview:
- Increased Risk of Infection: Older patients may have a weaker immune system, making them more susceptible to postoperative infections, including at the surgical site or deeper infections around the prosthesis.
- Blood Clots: The risk of developing blood clots, such as deep vein thrombosis (DVT) or pulmonary embolism (PE), is higher in older adults following hip replacement surgery, particularly if they have limited mobility during recovery.
- Anaesthetic Complications: Older adults may have an increased risk of complications related to anaesthesia, including respiratory or cardiovascular issues, especially if they have preexisting health conditions.
- Prosthesis Problems: There’s a heightened risk of issues with the prosthesis, such as loosening or dislocation, which might be due to weakened bones or tissues around the implant.
- Slower Recovery and Rehabilitation: Older patients often experience a slower recovery process, which can impact their rehabilitation progress. This slower pace can contribute to reduced mobility and, in some cases, lead to diminished independence.
- Fractures: During or after surgery, older patients are at a higher risk for fractures in the surrounding bone due to decreased bone density, which can complicate the recovery process.
Remember, the risk of any complication is extremely low, and your surgeon would never let you undergo the operation if the pros outweighed the cons. However, it’s important to understand the risks when choosing hip replacement surgery abroad.
Experience World-Class Results at Kardiolita Hospital
Kardiolita Hospital is a premier orthopaedic centre with a team of highly skilled surgeons ready to service patients from abroad. We specialise in delivering hip replacement surgery abroad for Irish citizens looking to avoid the lengthy queues and expensive costs associated with surgery in Ireland.
Don’t let hip pain hold you back. Learn more about our comprehensive hip replacement services at Kardiolita Hospital and take the first step towards a pain-free life today.