Octogenarian with multiple comobidities undergoes successful hip surgery

A private hospital in Delhi performed a successful hip bone fracture surgery of an 82-year-old woman having anaemia, uncontrolled diabetes, a barely functioning heart, the hospitals said on Sunday.

PSRI Hospital, which performed the surgery, said that the case involved a high-risk of mortality due to the patient’s multiple comorbid conditions.

“The patient was a diabetic and was under regular medication due to a serious heart ailment. Besides, she was also found anaemic amid the surgery. The case was complex and such patients generally carry a high risk of mortality,” Dr. Gaurav Bhardwaj, Director, Sports Injury, Joint Preservation & Replacement Surgery at the hospital said.

As per the hospital, the patient, Sita Devi, had suffered a hip ball fracture on her left hip after falling in her bathroom. The patient was taken to a nearby nursing home but doctors there refused surgery citing her heart condition and already frail condition.

“However, we took the risk. Her case was thoroughly assessed by a multidisciplinary team of doctors and paramedics including orthopaedics, physician for medical evaluation, cardiologist for her poor heart function, anaesthetist for pain management and nutritionist to ensure optimisation for early surgery,” Dr Bhardwaj said.

“She was also found to be anaemic after losing blood due to fracture and was dehydrated. Blood samples were drawn for lab tests, Intravenous fluids were promptly started and pain relief provided. Further, she underwent detailed cardiac check-up including stress ECHO which revealed a highly compromised heart working only on less than 20 percent efficiency. She also had deranged electrolytes which were corrected quickly.A Before operating the patient was informed about both the risks and the chances of recovery. Once the family’s nod was received, preparations for surgery were urgently done,” he added.

The patient was operated the next day to her admission in the hospital and was discharged two days later.

A 45-minute long surgery was conducted to implant her fractured ball with a metallic one.

“The broken hip ball was replaced with a metallic ball also called a half hip replacement. This implant has a special coating which fools bones to believe the implant is a natural bone and sticks immediately. This leads to quicker healing and significantly lower anaesthesia time, besides lowering the risk of heart and lung complications during the surgery,” the doctor said.

“After operation, the patient was in ICU for a day and later shifted to ward. And subsequently the patient was discharged,” the hospital added.

The patient is back on her feet after her surgery and indulging in physical activities to the level prior to her fracture. “Right after the surgery, I used to take help of a walker for my daily chores. However, with continued medication and sessions of physiotherapy, I am back to my physical activity to a level before my injury,” she said.