How common are post op fractures?

[ZAP]

Well we all have a post op waiting period before we can start wrestling tigers and bears again and my doctor told me its from risk of fractures.  I've gone through the site and couldn't find anything.  How often does this happen?  Have any of you ever heard of some one causing a fracture post op due to high impact?

[Dannywayoflife]

I "think" it accounts for around 1%. But the surgeon has a lot to do with it I've seen xrays where the femoral neck was notched by the surgeon and then obviously ended up fracturing. They can also disturb the blood supply which can cause a fracture. The first surgeon I saw told me about a case he did which had a failure at 6 weeks because he told the person they were ok to resume running 6 miles a day! The bone density takes 12 months to fully recover but fractures apparently normally occur in the first 6 months.

[hernanu]

I think Danny's got it right, Zap - I've read that there is a higher risk of fracture early on due to the stresses and blood loss to the bone from the surgery itself. 

The other, more major (2%?) causes of failure are also in play during this time, slippage and lysis. As long as you follow your instructions and are thoughtful about what you do, the percentages are well in your favor.  This allows the bone to grow into the device well, the bone to mend itself and your muscles to heal, to support the joint properly.

It's not a long time in perspective, but it does make for more successful hippys, which is what we want.

[morph]

Does any one know how long it takes the bone to grow into the device?

[Dannywayoflife]

It has been observed in a recovered BHR cup @3 weeks but Mr Treacy told me it usually takes around 12 months for the cup to be totally solid.

[David]

I've a friend who fractured his femur when he crashed on his mountain bike at 13 weeks.  Had to have his BHR revided to a THR.
When I asked about the risk of fractures Dr. Su mentioned a patient who did an extensive hike early on with a 55lb. pack and as a result a fracture as well.

[Dannywayoflife]

Im pretty sure that 12 weeks is a common time for these fractures to happen.

[Tin Soldier]

I think the case that David mentioned is the only one I've ever heard of, other than references to general stats as Danny and Hern poitned out.   I thought there was a pretty good discussion about this a few months back.  Also, Pat posted an article from a lesser known, but experienced HR surgeon that discusses in depth about bone growth, timelines, the importance of moderating your activities during the 12 month long recovery period,... I'll see if I can put up a link to it. 

There is a fair amount of discussion here about the recovery period and starting running or other similar activities.  I think the most likely time to fracture your femoral neck is after the initial 6 week recovery but within 6 months.  I think this may have more to do with the individual either thinking they are good to go early on, or maybe an inexpereicned surgeon suggesting that the individual can start doing those activities again before 6 months.  6 months is the absolute mimnum, but most surgeons prefer one to wait 12 months before getting abck into a serious athletic mode.   

[Neild5]

This is what was explained to me by 2 different doctors:
There are 2 issues with hip restrictions, first is the 90 degree and the rest of the dislocation warnings for typically 6 weeks.  This is to allow the muscles and tendons that were cut or moved during surgery to heal.  The breakage concern is from all the work done on the bones, if the surgeon nicks the neck of the femur it will put a stress point that can break the neck.  Also the reamers for both the femur and acutabulum  disrupt the blood supply to the bones and the femur is at its weakest at about the 3 month PO point.  At 6 months the fracture risk  has dropped close enough to zero, but actually the healing process can take 24 months.

[Dannywayoflife]

I thought the 90 degree rule was due to small head thr's? Most surgeons I've spoken to over here don't have the 90 degree rule.
The surgeon shouldn't notch the neck(but im sure some do probably down to lack of experience) I think the main reason for this happening is the disturbance to blood supply and too early return to impact and loading(just my opinion)!

[PistolPete]

I met someone that had a BHR done several years ago and he slipped going down the stairs.  He landed on his operated leg and thought nothing of it.  Soon after this he started feeling pain which he ignored until it became severe.  When he made an appointment with his surgeon it was determined that the fall killed his femer so he needed a revision.  He now has the Mini-hip and is totally happy with it.

[Dannywayoflife]

At what stage in recovery was he pete?

[obxpelican]

Does any one know how long it takes the bone to grow into the device?

At 6 weeks a layman could discern some bone ingrowth in my cup, at one year is was very noticeable.

Chuck

[bilateralbliss]

12 weeks is the most common time I have heard, though probably only if overdoing it. As others have mentioned, it takes a full year. PT in hospital where I had mine done did tell me he`d only ever heard of two people having trouble, one fell down stairs, the other had a car crash, so both were actually unrelated to the actual procedure.

[hipnhop]

Man, i fell off my bike a few times and no problem.  I think these things are locked in. Just make sure you rest and eat well so your body can repair after intense workouts.  I am learning that know.  You should be cool unless you get hit by a bus.

Hip

[Jason0411]

I fractured myself 7 weeks post up but not the normal femoral neck fracture. I managed to crush the head of the femur under the cap by tripping. I am on the mend now but it is a very rare fracture as according to Mr McMinn if i recover I will be the first he has known of in the Uk and he only knew of two other people in the world who had recovered from that kind of crush fracture. apparently the fracture would usually cause the femoral head to crumble in the first three months.
I am 6 months post fracture.

[hernanu]

Man, i fell off my bike a few times and no problem.  I think these things are locked in. Just make sure you rest and eat well so your body can repair after intense workouts.  I am learning that know.  You should be cool unless you get hit by a bus.

Hip

Good to hear you're doing well, hip - I didn't get hit by a bus, but rear ended (in my car) hard by an illegal u turning octogenarian at full speed at 5 months on the second hip and it held up fine. I think you're right, dancing without mosh or break dancing should be just fine.

[obxpelican]

As someone else had mentioned, neck notching is what causes so many of fractures. 

In the end you will find that experience matters, if you choose an experienced doctor with good numbers your chance of a misplaced cup or fracture are very small, if you choose a doctor who is inexperienced you will double or triple your chances for complications.

We say it over and over on this forum, experience matters, if you choose an inexperienced doctor you do so at your own peril.



Chuck

[ZAP]

I fractured myself 7 weeks post up but not the normal femoral neck fracture. I managed to crush the head of the femur under the cap by tripping. I am on the mend now but it is a very rare fracture as according to Mr McMinn if i recover I will be the first he has known of in the Uk and he only knew of two other people in the world who had recovered from that kind of crush fracture. apparently the fracture would usually cause the femoral head to crumble in the first three months.
I am 6 months post fracture.

Tripping off of what, a cliff??   I don't understand how you can fracture after 6 months pre op from trip..  Can you give us more information?  How athletic are you, age, experienced doctor, etc??

[Jason0411]

I fractured myself 7 weeks post up but not the normal femoral neck fracture. I managed to crush the head of the femur under the cap by tripping. I am on the mend now but it is a very rare fracture as according to Mr McMinn if i recover I will be the first he has known of in the Uk and he only knew of two other people in the world who had recovered from that kind of crush fracture. apparently the fracture would usually cause the femoral head to crumble in the first three months.
I am 6 months post fracture.

Tripping off of what, a cliff??   I don't understand how you can fracture after 6 months pre op from trip..  Can you give us more information?  How athletic are you, age, experienced doctor, etc??

I tripped 7 weeks post op whilst helping in the dining room at work. I didn't fall but stamped my foot down hard to stop myself falling I was walking at speed. The impact caused the cap to crush the bone beneath which obviously had not hardened enough. I am a big bloke and in the catering industry we have to shift a bit to get people served. I am 45 years old. I was working as if I had never had anything done but that is what my family do. Too much too soon.

If you read my post I am 6 months post fracture now, not 6 months post Op.