Hip replacement now more viable for people over 80

Velma Jones was tired of the crippling pain and stiffness in her left hip that made it difficult for
Working in the kitchen of her Delmar home on Thursday, Velma Jones prepares oatmeal cookies for a church reception. The 93-year-old Jones had a hip replaced three years ago and has enjoyed a better quality of life since then.
PHOTOGRAPHER:
Working in the kitchen of her Delmar home on Thursday, Velma Jones prepares oatmeal cookies for a church reception. The 93-year-old Jones had a hip replaced three years ago and has enjoyed a better quality of life since then.

Velma Jones of Delmar was tired of the crippling pain and stiffness in her left hip that made it difficult for her to walk.

“It was quite bad,” said Jones. “Even cortisone shots didn’t help.”

So Jones, at the age of 90, decided to have hip replacement surgery.

For men and women over age 80, hip replacement may still be a viable option, according to a study published in the December issue of The Journal of Bone and Joint Surgery. Patients 80 and older are experiencing hip-replacement outcomes comparable to those of their younger counterparts.

“We’re seeing more and more older people,” said Albany orthopedist Dr. Paul Hospodar of the Capital Region Orthopedic Group. “No one wants to toss in the towel. They want to remain active.”

“Sitting in a wheelchair having people wait on you for everything gets old after a while,” added Jones, who had the surgery three years ago. Now 93, she is contemplating having her right hip done sometime in the spring.

“I’m tired of having it hurt,” she said.

Of course, age is always relevant to any operation, said Hospodar.

“The older you are, the higher your chances of having something like a heart attack or a stroke during surgery,” he said. “But with modern anesthesia and regional anesthetics, the risk of having those problems has diminished. But it is still there. The recovery is also a little bit slower.”

Age is risk factor

Although she had some pain for about a week after the surgery, Jones said she felt hopeful that the surgery was a success, and she tried to be cheerful during her 10 days of physical therapy.

“I think it helps if you have a positive attitude,” she said.

Jones, who enjoys gardening, reading and cooking, said she used a walker for a couple of months after the surgery, and she took pain medication for a couple of weeks.

Today, she walks long distances with a cane, because her right hip hurts. She walks unassisted in her house.

“Hip replacement is the best operation that an orthopedic surgeon has,” said Hospodar. “By far, my happiest patients are the ones I do hip replacements on.”

Total hip replacement involves replacing the worn out femoral head, the ball of the thighbone, with a metal ball. The metal ball attaches to a metal stem that fits into your thighbone. A plastic and metal socket is implanted into your pelvic bone to replace the damaged socket.

The prosthetic parts, which mimic the natural design of your hip, fit together and function like a normal hip joint.

“The only downside to the operation is the risk of dislocating the hip or infection, but these are very uncommon problems,” said Hospodar. “When it works, which is about 90 percent of the time, it works extremely well.”

Although it takes people over 80 slightly longer to heal, Hospodar said most people come through the operation very well.

“There isn’t a lot of rehabilitation. So it’s an easy operation for an older person to deal with,” he explained. “It becomes a quality-of-life issue. Most people would rather have a higher quality of life than suffer the rest of their life with the pain.”

While a decade ago it was almost unheard of for people in their 80s and 90s to have hip replacement surgery, Hospodar said it is becoming more common as people live longer.

Not Designed for young

Still, the majority of people who have the surgery are in their 60s and 70s, said Hospodar.

“We prefer to do people in that age group because they are usually more moderate in their activities. If you put it in a 30- or 40-year-old, they will wear out pretty quick because they want to play tennis or basketball and that’s not what hip replacements are meant to do.”

While the technology is getting better, Hospodar said hip replacements are meant mainly for walking, and they are expected to last between 15 and 20 years.

Pain is the main reason people need hip replacements, said Hospodar.

Symptoms that might lead people to consider hip replacement include:

— Pain that keeps you awake at night.

— Little or no relief from medication.

— Difficulty walking up or down stairs.

— Trouble standing from a seated position.

— Having to stop activities you enjoy, such as walking, because you are in too much pain.

“As long as people can get around, we don’t do it,” Hospodar said. “But if the quality of their life is such that they are spending more time sitting in a wheelchair, the person has to decide. So it’s really a quality-of-life issue.”

Jones said she is looking forward to having her right hip done in the near future.

“I can’t do as much gardening in the summer as I’d like, because I can’t bend over,” she said. “So it will be nice to be able to bend pain-free again.”

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