Volume 24, Issue 104, July - August, 2020

Revision of total hip replacement surgery in elderly patient and its recovery based on periprosthetic fracture rehabilitation

Laukik Vaidya, Kiran Kumar^♦, Waqar Naqvi, Simran Narang, Gajanan Pisulkar, Mohit Dadlani

Ravi Nair Physiotherapy College, DMIMS (DU), Sawangi (Meghe), Wardha-442004, Maharashtra, India.

^♦Corresponding author
Associate Professor and HOD, Musculoskeletal Physiotherapy; Ravi Nair Physiotherapy College, DMIMS (DU), Sawangi (Meghe), Wardha-442004, Maharashtra, India; Orcid Id: orchid.org/0000-0003-4615-418X Email: kiran.kumar@dmimsu.edu.in

ABSTRACT

Introduction: Slip and fall accidents are associated with 87% of hip fractures and elderly people (Soangra and Lockhart, 2017). Factors such as muscle weakness, impaired postural control and balance are associated with falls in older people. Falls causes reduced independence, function, mobility, confidence in mobility, and quality of life (Hill et al., 2016). Patients with periprosthetic fractures are typically elderly, frail and have osteoporosis. It has advantages of early mobilization, reduced hospital stay and reduction in complications such as mal-union and nonunion (Marsland and Mears, 2012). Case: A 72-year-old male shopkeeper with right-hand dominance complains that day-to-day tasks such as sitting cross-legged, squatting is difficult. He had a slip and fall back 2 years in the toilet on the left side and sustained injuries to the left arm and hip. Investigations revealed dislocation and loosing of prosthesis of left hip, hence revision surgery was done where bipolar prosthesis was removed and cemented total hip arthroplasty was done where a midshaft femur fracture of same side was found. 7 screw plating proved to be insufficient and unstable, and came out of its place. An open reduction internal fixation was done with trochanteric bridge plating, screws and 4 titanium banding cable-2 at the trochanter in April 2020 and was given open knee brace. Conclusion: In conclusion, this case report demonstrates that patient with periprosthetic fracture with revision total hip replacement and revision surgery for displaced midshaft implant. Patient was able to resume activates of daily living and grooming on his own.

Keywords: Total hip replacement, rehabilitation, Periprosthetic Fracture, implant, Bridge Plating

Medical Science, 2020, 24(104), 2628-2638

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