How risky is high risk hip surgery?

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How risky is high risk hip surgery?

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I'd consider getting a second opinion - some doctors are keen to over-treat, other doctors are more concerned about a death they might be blamed for. I'd also ask how they would prep and check your father - not just rely on him at home.

My mother aged 78 had major surgery for cancer when she was on Warfarin
(blood thinner) plus other meds for high cholesterol and high blood pressure. She was taken into hospital for 10 days while they dropped the Warfarin and monitored all her other med problems (3 blood tests a day). She survived the surgery, but she died three months later from the cancer and the time would have been more comfortable without the surgery. We had another problem with her Oncologist, who wanted another round of chemo and was clearly into as much expensive treatment as possible. Her specialist Physician had a noisy argument about it with the Oncologist just outside her hospital room.

At 72, your father's comfort and mobility for the rest of his life are important. Does he understand the risks, and what is his own opinion?

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Do research on how is hip surgery done? I've been told that the patient is hung upside down for this surgery ....ok. I'm ignorant about this, but friends have informed me that this is how hip surgery is performed.
Is your ailing father aware of this? Is he robust enough to withstand major surgery upside down?
I'd be very cautious about this, and please ask around....if possible, talk to at least 3 others who have undergone this procedure. May God be with you and your father during this difficult time.

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I'm so sorry to hear that he has a lot of health conditions at just 73. He may get through the hip surgery okay, but is he willing to to the therapy that comes after the surgery? I knew one gentleman who had both hips replaced and his doctor told him to walk and walk and walk and walk some more.

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Not sure about the chf your dad has. Do you know what stage he’s in? My mother has stage 4 chf and I can’t see her having any surgery at this point. Does the cardiologist think he can handle it?

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My mother in law has had 8 hip surgeries on the same hip in a time frame of a year and a half. Of those 8, 5 were complete replacements and three were dislocations. She had anaesthetic each time. She now has no short term memory and is in a home. Her long term memory is there to some extent but she is confused most of the time. For a retired nurse this has been devastating. She is 88 years old now and often speaks of wishing she were dead. The only excuse, provided by the surgeon, for this was that her bones were soft. There used to be an ad on the television about a class action suit against several hip manufacturers. We often wondered if they used defective parts or is it all because of her soft bones. We will probably never know the answer.

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The thing that really worries me is the Afib Im pretty sure he has to be on some sort of blood thinner for that now when anyone has surgery you have to stop blood thinners before during and after the surgery for a bit of time then they put him back on thinners when risk of bleeding too much has passed also the CHF along with the AFIB I would be so afraid of heart attack this happened to two seperate people I know that had these same sicknesses I just do not know what you should do any surgery is EXTREMELY DANGEROUS FOR elderly people. 73 is not that old but surgery can make you old ....

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You are exactly correct. He has to come off of his blood thinners prior to surgery and with multiple cardiovascular issues the threat of stroke or other cardioemobolic event is very high. Living with reduced mobility from a weak hip is unpleasant but is much easier than living with brain damage from stroke. That is the risk-benefit assessment you have to make. Get a few opinions before deciding, but be very cautious.

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My father fractured his hip in a fall last summer ie 89 yrs old and still very physical active .. had surgery and went to rehab ... it was a slow recovery and was working hard at it and pT but never felt comfortable walking wo assistance and after 6 weeks contracted mrsa which went to his heart and became septic ... rather than prolong with feeding tubes etc , he died in hospice .. 2 months of hard work down the drain and he got sick so quickly .. I still wonder if I should have been more aggressive with rehab and ultimately more aggressive with his infection with putting in feeding tube etc

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My dear MIL had a knee replacement years ago, but never fully recovered cuz the physical therapy work was too much for her. That's why the knee just froze up, & even though she could walk, it was dangerous on stairs, & she never could bend that side again. (That led to her tripping & falling more frequently). She broke her arm during a fall the following year. Honestly, the same could happen with a hip surg cuz elderly cannot tolerate the painful rehab work required afterwards. Just want you to know that Drs make it sound great, but it's BSh#t.

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I can only speak from my own experience so of course, make your own decision. My father at age 92 was like a 70-year-old. Very mobile, few health problems, mind sharp as ever. He was becoming shaky on his feet and one night he fell and broke his hip. There was no choice but to do a full hip replacement. He nearly died 3 times during recovery to the point they called us in to make end-of-life decisions. Fast forward, his body healed, but his mind has never been the same. I spoke with his internal medicine doctor and he said he sees this all the time. He doesn't know what causes dementia after a major surgery such as hip replacement, but he suspects it is the anesthesia or lack of the exact amount of oxygen to the brain during surgery. He admitted he is guessing, but says there is definitely a connection to the mind and surgery. If you have a choice, and his mind is good, my suggestion is do not encourage it.

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Same thing happened to my Mom when she was 80. After hip surgery she was never the same mentally. She did show some signs of dementia prior to the surgery but it wasn't bad. The doctors say the anesthesia took her over the edge. Sometimes this happens to the elderly after surgery at no ones fault. Its been 8 years and she is now in a NH due to full dementia.

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Look into the anterior approach to hip replacement. Recovery is MUCH faster and easier than the old-style approach, no muscles are cut — just stretched. You can walk on it the first day and it can even be done as an overnight surgery in an outpatient clinic. Minimal to no chance of dislocations. Really a revolution in hip replacement techniques! I am 71 and have had both hips replaced with this method — one 9 years ago and one 5 years ago. No complications. Yes, you’re in bed with cold packs for a few days. And you still have to do your physical therapy. But if you ARE going to risk hip surgery, I highly recommend going this route.

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There are certain criteria a surgeon uses to determine if the hip replacement can be done via the anterior approach. I had mine done this way and have a persistent pain in my thigh due to manipulation of a superficial nerve. Nerve pain is really painful.
Anterior replacement can't be done on obese people. I remember that was part of the criteria.
I myself had great results but this nerve pain is terrible.

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My first stop would be his cardiologist, they know what percentage his heart is functioning at and if this is even an option for him. It may not be the actual surgery but rather the anesthesia that he will not survive. Are there other alternatives other than totally hip replacement? Is it due to arthritis they are suggesting the surgery or something else? Try to get as much information before making a decision. Get a second opinion from a top rated surgeon (insurance companies will pay for a second and third (if needed) opinion. Information is your best friend right now so everyone can make the best decision regarding his surgical experience.

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My husband is 74 and having serious pain from bone on bone pain in both hips. He has arthritis, osteoporosis, and degenerative joint disease. He already uses a walker and has to walk bent forward because of the stenosis in his lumbar vertebrae. He has already had a hemorrhagic stroke 5 years ago; he has vascular dementia and COPD with heart failure (diastolic). Being active is an important part of controlling his heart failure and reducing the progression of his dementia. The hip problems are really slowing him down.

Nothing has been decided about his hip disposition, but the comments from those that have faced this issue are very helpful. Thanks for sharing your experiences.

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My mom just turned 94 and fell and needed partial hip replacement b/c of so much pain. She made it through the surgery and went to rehab for 21 days and was released to go home. She came to my home while she gets more in home OT and PT and I just can’t see how she’ll go back home. She doesn’t want to eat like she should, do physical therapy like she should. I do not know what will happen going forward. If she didn’t break her hip, I would figure something else out before I would do surgery. Hoping for the best for you! I would also welcome thoughts from others in a similar situation.

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Any Surgery is Risky and the Older One gets, The more Risky and the Less Chance of Full Recovery.

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It’s a shame doctors never consider delirium, only dementia, when a senior goes into hospital for surgery, with mind intact, and comes out with a dementia diagnosis. They have similar symptoms, but dementia doesn’t normally happen without a process. No doctor, but my family has instructions should I ever have anesthesia, which I will with three joint replacements on the horizon, that I’m not going in with dementia, and if I come out with it, I am to be assessed for delirium. Like patients with IBSD, dementia patients deserve so much more diagnostic effort than is often given.

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Once again I thank you all for your stories, ideas, solutions, and answers. I did get my father to the doctor just yesterday and his doctor said no way for the surgery he is extreme high risk which really sucks. It was an extreme effort to get him there however I took him there and he was evaluated by amazing nurses and doctors. I guess some people are inoperable and that’s just the way life goes... thank all of you good people for your help.

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Thank you for the update. I hope your dad can get some help with his current medical issues and feel better because of that.

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Would physical therapy help him? Is he in pain? Does pain keep him from sleeping? I'm 76 and I have declined hip surgery although many doctors/friends/PTs advise me that hip surgery might relieve hip pain. I have seen hip surgery work, but I think a lot of my pain might result from muscles--not joints. I saw a pain specialist who gave me a ketamine/lidocaine cream that works great. I put it on before bedtime so that pain doesn't keep me awake. You can purchase lidocaine roll on dispensers and lidocaine patches at pharmacies. Salonpas makes some good products. If your father can strengthen his hip flexors and extensors such as the thigh muscle and hamstrings, they might be able to help him move his limbs walking without jamming the joints together. This website describes non surgical treatments for hip arthritis: https://www.impossible-takes-longer.com/

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Thanks for the information - very helpful ideas.

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I am 80 and also have diabetes and high blood pressure, as well as as heart problems. I have a totally collapsed hip and my doctors I have seen know that my hip is in terrible shape but the hospitals of John Hopkins, Charlotte Medical and Chapel Hill have told me point blank my
undergoing a hip replacement would be so risky, chances are I would not live through the surgery. The medical risks are hip for someone in good health but anyone with the additional issues, has an even less chance of surviving. I have some friends in my age group. Three had surgery, 2 did not survive, the 3rd one still copes with extreme pain and has more and more difficulty in getting around. This is something you need to very carefully weigh and maybe you might decide to have him see a good, very good pain management specialist and be on
chronic pain management as well as some physical therapy.

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After reading your post, I feel less worried about my decision to avoid hip surgery so I thank you for that. It is comforting to me to see other seniors living and coping without surgery although I recognize that you are forced to forgo hip replacement because of medical conditions--not because you want to avoid it. I'm scared of surgery, anesthesia, and reactions to titanium or metal elements in the hip device. I have felt pressured to undergo hip replacement. It's almost as if I'm entering a fire sale: "You should do it now before it's too late." Perhaps you are an example of what happens when my medical condition will no longer allow hip replacement. In that case I am less worried.

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Problemsolve: As I said, hip surgery requires one to walk A LOT afterwards. A neighbor had to do this.

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How risky is high risk hip surgery?

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