Dr. Su Femur fracture
Because the bone of the femur is retained, it is possible to fracture it after surface replacement. Most of the fractures occur early in the post-operative period if too much weight is put on the leg too early. The body needs time to adapt to the new prosthesis. Post-operatively, crutches are used for 3-4 weeks to protect the amount of weight put on the leg. With current techniques and rehabilitation protocol, the risk of fracture is less than 2%.
Dr. De Smet What is the worst complication that you are aware of with resurfacing?
Fracture of the neck of femur. When it occurs, you get a stem with a big modular head. I have only one patient with this, but afterwards he is now, one of my happiest patients. In most of the series, all over the world, fractured neck of femur has an incidence of 1%.
Dr. Gross Femoral neck fracture is the most common complication after hip surface replacement (HSR). It occurs in 1% of all patients. It most commonly occurs 3 months after surgery. After 6 months the bone is fully recovered from surgery and fractures no longer occur (similar fracture chance as the average population).
At this point it is known that women have a higher risk of fracture than men. Also, elderly patients have a higher rate than younger patients. To better assess individual fracture risk after surgery, we are now obtaining DEXA scans routinely on all patients. No published data yet exists regarding fracture risks related to a specific DEXA score. However, logic dictates that patients with lower scores may be at higher risk. Furthermore, the risks in these patients may be reduced if additional precautions are taken.