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Dr. Andrew Rynne

Family Physician

Exp 50 years

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MRI showed femoral head with multiple fractures. Safe to go for total hip replacement surgery?

Answered by
Dr. Saurabh Gupta

Orthopaedic Surgeon, Joint Replacement

Practicing since :2004

Answered : 5930 Questions

Posted on Tue, 22 Jan 2013 in Bones, Muscles and Joints
Question: Age: 51
Gender : Male
Habits : Alcholic
Sugar : Nil( Had traces of sugar in earlier tests)
1) For last six months my dad was unable to walk properly due to problem in hip. Doctor after taking MRI they suggest THR for my dad for his hip. They said femoral head has multiple fractures..
2) does ceramic THR implant preferable. I heard it has less track record because it was new technology? Please suggest the best implant with manufacturer..
3)What will be approximate cost of THR with ceramic and steel implant in India?
4) Is it suggestible to go for THR or do he has any other alternative?
5) What will be the life of both ceramic and steel implants?
6) Will there be any impact to his normal life after this surgery?
7) What facility we should look in the hospital before I choose some surgeon for this operation?
At present he is using some homeopathy medicines, we are not sure if he can go for the surgery. So I want to consult many specialists before I can go for surgery

He has pain in the affected leg(Right) knee

He is able to walk only 15-20 meters after that he is feeling pain too much

He is able to ride bike

1) Will there be any side effects in case the operation is delayed for some more days?
2) What are the expected side affects post operation?
3) Is there any alternative rather than this surgery?

Please understand this is critical stage for my dad, so I am looking for some detailed explanation from you.
Answered by Dr. Saurabh Gupta 2 hours later
Thanks for posting your query. I have gone through the report attached with the query.

Before making a decision about what type of hip replacement is best for your father, understand the known risks and benefits of what is available for use, and remember that new may not mean better or longer.

There is no consensus in the orthopedic community regarding the single “best” bearing or material. The choice generally comes down to your surgeon’s preference. Each surgeon has innumerable reasons for choosing one device over another, including his or her personal experience as well as tool and implantation method preferences.

Because of its durability and performance, Metal-on-Polyethylene has been the leading artificial hip component material chosen by surgeons since hip replacement surgeries were first been performed. It is also the least expensive bearing.

Estimated cost for ceremic on ceremic is Rs 1,00,000 and metal on metal is Rs 1,10,000.

Your father will be able to resume most activities; however, he may have to change how he does them. For example, he will have to learn new ways of bending down that keep his new hip safe.

Hospital should be well-equipped with orthopedic operation theatre, well trained staff familiar with THR, having ICU facility.

It is an elective operation so can be delayed for some more days without any side effects.

As such there is no side effects after operation but complications an occur.Most complications in total hip arthroplasty are infrequent and can be prevented or treated readily if anticipated and recognized.

Total hip replacement is best for your father, if pain persists after conservative management.

I hope this answers your query. I will be available for further guidance if you needed.

Wishing you good health....

Dr Saurabh Gupta.
Orthopaedic surgeon
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
Follow up: Dr. Saurabh Gupta 9 hours later
how many days the operation can be delayed doctor? if at all he chooses to lead without operation, can he be normal. will there be any effects to nervous system or spine?
Answered by Dr. Saurabh Gupta 11 hours later
Thanks for writing back.

It will depend upon grade of joint destruction and severity of symptoms. Without operation, he might have to limit his activities due to pain and joint destruction. If condition is not corrected secondary arthritis may develop over spine, knees and ankles.

I hope this answers your query. I will be available for further guidance if you needed.
Please close the query if you have no other questions.

Wishing you good health...
Dr Saurabh Gupta.

Above answer was peer-reviewed by : Dr. Mohammed Kappan
Follow up: Dr. Saurabh Gupta 1 hour later
So what is your comment on condition of the joint destruction in the MRI report. He has the knee pain of the effected leg now and cannot walk more than 20 mtrs. so based on the current situation what is your comments on delaying the operation?
Answered by Dr. Saurabh Gupta 1 hour later
Thanks for writing back.

In MRI report there is avascular necrosis of femoral head which is in advanced stage and at this stage it is irreversible .So in my advice he needs total hip replacement at this stage. So delaying the operation is not a good option.

I hope this answers your query.

Wishing you good health...
Dr Saurabh Gupta.

Above answer was peer-reviewed by : Dr. Aparna Kohli
Follow up: Dr. Saurabh Gupta 15 hours later
So do you have any idea which hospitals in andrapradesh are good for this operation and who can do this surgery well.

Can you provide me a list of doctors in andrapradesh and the average hospitalization cost of those doctors?

Answered by Dr. Saurabh Gupta 6 hours later

Hospitals in Andhra pradesh which I have heard that are good for joint replacement are-
Apollo hospital, Medwin hospital XXXXXXX hospital.

The average price will vary and you would need to find out from the individual hospital

Dr Saurabh Gupta
Above answer was peer-reviewed by : Dr. Aparna Kohli

The User accepted the expert's answer

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