When the thigh bone breaks around the stem of the hip replacement, it is called a periprosthetic fracture. This can typically occur with a fall from a standing height in frail bone, or trauma with high energy (e.g. a road traffic accident). Not all periprosthetic fracture require revision surgery (the stem to be taken out and the new one put in). Sometimes these fractures can be fixed with plates and screws and the old implant retained.
In the case on the right the broken thigh bone (femur) has been fixed so well that the fracture line cannot be seen. The femur is held with plates and screws around the implant. This 90 year old lady was then walking with all her weight on her leg the next day.
Reaction to metal ions and metal allergy
Metal on metal hip replacements have been implanted in the past and you may have heard about them in the media. This is when both the socket and the ball of the artificial joint are made of metal. This can generate metal ions locally around the hip joint, which then causes an inflammatory reaction leading to loosening and local destruction of tissue such as muscle and bone around the hip. Very rarely, patients can be allergic to some types of metal used in implants. This can cause pain. There is no definite consensus among orthopaedic experts regarding this; further research into this area needs to be conducted.
What if you need a revision total hip replacement?
The prospect of having revision surgery can be very daunting for you. Rest assured, I will perform a thorough medical evaluation to determine your fitness for surgery. A number of tests will be performed to ensure we have the right diagnosis and meticulously plan the surgery.
Your mobility will often be temporarily limited after surgery. Depending on the surgery performed, crutches will be required usually for a period of 6 weeks and sometimes 12 weeks. Therefore you may need help with tasks of daily living, such as cooking, shopping, and bathing.