General Question

skfinkel's avatar

Should a 90 year old man get an old hip replacement repaired, plastic is broken, but no pain?

Asked by skfinkel (12877 points ) November 7th, 2010

Surgeons say that the hip should be repaired, and the surgery will be less dramatic than the original, but he is not in pain. What we are hearing is that the plastic breakdown could be bad, but having trouble finding out about what actually happens to the plastic in the old hip.

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18 Answers

choppersangel's avatar

Looks like a decision that has to be based on lots of information. The gentleman may not be in pain, but is he in danger? Might the joint collapse in some way if not seen to? The main risk would be in the actual surgical intervention, time under anaesthetic, possibility of infection etc. At 90, if he is hail and hearty, it may be that living with the damaged hip could be an easier option. Not something that can really be answered without considerable expertise, but good luck anyway.

Coloma's avatar

I agree with @choppersangel

If the risk of living with the situation is less than the risk of another surgery I’d opt for the former.

All surgery poses risk and at such an advanced age the risk of infection, pneumonia etc. are serious factors to weigh in.

At 90 he has already ‘won’ the game if life by a substantial margin considering the average lifespan of the male of the species stands at 76.

Coloma's avatar

P.S.

Don’t forget that doctors are in business and will recommend another surgery if it means more money in their pocket. I’d definitely glean multiple opinions and do a lot of research rather than take one doctors word as gospel.

skfinkel's avatar

Thanks for the answers. The real question is what could happen to the broken plastic in his body? If nothing horrible, we certainly could wait…

Seaofclouds's avatar

How long has he had the current hardware in? I agree that you have to measure the risks of him getting injured and requiring more intervention over the risks of the surgery. Since the plastic is already broken, I wonder if pieces of it could break of and damage the surrounding structures.

skfinkel's avatar

@Seaofclouds That’s exactly the problem we are considering. How much damage could it do? At 90, could he live another five years with this?

skfinkel's avatar

I haven’t been able to find out what happens to the plastic in his body with the breakdown of this hip replacement.

Seaofclouds's avatar

@skfinkel I don’t know anything for sure, but I imagine if a piece were to break off and it had a sharp edge, it could tear into the surrounding tissues. Considering the femoral artery isn’t to far from the hip, I’d be very cautious. As far as the plastic breaking down chemically, it depends on the chemical composition of the plastic they used. Is there any way you can get in touch with the original surgeon and get some information from them?

skfinkel's avatar

@Seaofclouds The original surgeon is the one who recommends this be fixed. We really don’t have a good sense of what can happen to the plastic. Obviously, if the plastic cuts an artery, that would be disastrous, but we have no idea if that is a real possibility.

Seaofclouds's avatar

@skfinkel Did the surgeon discuss with you exactly how it is broken at this time? Can you ask them what the risks are if you don’t have the surgery at this time? They should be able to discuss those things with you. If not, perhaps seeing a different surgeon would be a good idea.

skfinkel's avatar

@Seaofclouds I agree with you. I think we need another conversation with the surgeon to get more information. Thank you.

poisonedantidote's avatar

<—NOT a Docrot.

All i know, is where i live, no doctor would want to operate on a 90yo man without very good cause. The only reason i can think of, is if it where an immediate threat to his life. I would be worried that this was all just to get money out of the insurance.

Ask another docrot, or two more, what they think.

choppersangel's avatar

Docrot! Daft chapfromalienplace! (@poisonedantidote) Methoughts are again as above, and echoed by @Coloma. You could probably find out quite a lot just with an internet search, about the stuff the plastic hip is made from. When was it fitted? The plastics used for surgery are designed to be inert, I wonder if there is any real risk of it ‘cutting’ through anything? More that the support it provides may simply crack, or crumble. That is when pain would become an issue. Definitely a chat with another Docrot should help.

desertr0se's avatar

I would get opinions of several physicians. At 90 years of age, surgery could be life threatening.

john65pennington's avatar

If there no immediate pain for him and the old plastic does not present a health problem for him, leave it alone. he is 90 years old and the surgery might just kill him. if he survives, he also may never heal from this major surgery. my mother had this surgery at the age of 87. she never recovered and now is a cripple in a nursing home.

I do not recommend it. i am not a doctor, but i know the heartbreaking future he may face, if this major surgery is perfomed at his age.

rooeytoo's avatar

This may sound facetious but I truly don’t mean it in that way, but, has anyone asked the gentleman himself what he wants to do?

If he is of sound mind it should be his decision.

skfinkel's avatar

@rooeytoo: this question comes from the gentleman in question, who is of sound mind and body, and is concerned about moving forward on such an operation, even though it has been recommended by his doctor. This decision will be 100% his.
@john65pennington: so sorry to hear the story of your mother, and thank you for sharing that.

rooeytoo's avatar

@skfinkel – good, I couldn’t be sure based on how the question was posed. In that case I agree with the get another opinion responses. My dad had surgery for a double hernia at age 87, it was not a choice for him because there was danger of strangulation. He came through with flying colors. So surgery at that age does not necessarily mean dire consequences are inevitable. If it were me and it meant I would retain my mobility and independence, I would do it in a flash!

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