• RATE YOUR SURGEON ON OUR NEW JOINT SURGEON LOCATOR

    Your opinion matters so please click on this announcement to find out how to rate the surgeons you have worked with

    You could also go to the Surgeon Locator via the blue nav bar at the top - find the tab "Surgeon Locator"

Watch 2019 JRAD Videos

THR Hip replacement question after failed femoral neck fracture repair with screws

Laskyd

junior member
Joined
Oct 14, 2019
Messages
56
Age
63
Gender
Female
Country
United States United States
Is anyone facing a total hip replacement after developing AVN or nonunion with a femoral neck
repair surgery?

I fell down a flight of stairs on June 30 and fractured my femoral neck. After 10 weeks of recovery with limited weight bearing, I ended up developing necrosis of the femoral head and now I need a THR.

Before this trauma I was a very active energetic 63 year old woman who hiked up mountains. Now I cannot walk in my house without using a cane because of severe pain in my groin.

My question is what surgical approach is best for my case— posterior, anterior, anterolateral?
I have seen many surgeons and I am getting different recommendations without a consensus.

By the way, if you know any excellent surgeons who do hips in the Washington DC, Maryland or Virginia area, I would really appreciate hearing about them!
This whole ordeal terrifies and depresses me!
Thank you So much for your help!
 
Last edited:

Pumpkln

MODERATOR
Moderator
Joined
Oct 27, 2011
Messages
21,613
Location
United States, West
Gender
Female
Country
United States United States
@Laskyd,
Welcome to BoneSmart, glad you joined us! :welome:

Sorry to hear of your failed hip pinning.
The most important decision is to pick a highly skilled surgeon, they will use the approach they have the most experience with and have had excellent outcomes.
The outcomes for all 3 approaches are similar.

If you are at the stage where you have joint pain but don't know for sure if you are ready to have surgery, these links may help:
Score Chart: How bad is my arthritic hip?
Choosing a surgeon and a prosthesis
BMI Calculator - What to do if your surgeon says you're too heavy for joint replacement surgery
Longevity of implants and revisions: How long will my new joint last?

If you are at the stage where you are planning to have surgery but are looking for information so you can be better prepared for what is to come, take a look at these links:
Recovery Aids: A comprehensive list for hospital and home
Recliner Chairs: Things you need to know if buying one for your recovery
Pre-Op Interviews: What's involved?

And if you want to picture what your life might be like with a replaced hip, take a look at the posts and threads from other BoneSmarties provided in this link:
Stories of amazing hip recoveries
 

Celle

MODERATOR
Moderator
Joined
Nov 19, 2011
Messages
36,233
Location
New Zealand
Gender
Female
Country
New Zealand New Zealand
Hello @Laskyd - and :welome:

it's not the approach to a THR that is most important - It's the skill of your surgeon. All approaches to hip replacement give good results, but not all surgeons do.

It truly is the skill of your surgeon that's the most important factor for success. So, instead of searching for a surgeon who will do your chosen approach to hip replacement, look for a surgeon who has teh skill and experience you need.

You need to look for a surgeon who specialises in hip and knee replacements (not a general orthopaedic surgeon and not a sports accident repair surgeon) and who does at least 100 joint replacements in a year.He/she also needs to have a low rate of infection amongst his/her patients.

This article may be helpful for you;
Choosing a surgeon and a prosthesis

You could start your search by using our Surgeon Locator in the blue band at the top of the page. it's still not a complete list, but you could sort out some "possibles" and then start phoning their offices to find out more.

If you have no success doing that, post your Zip code in this thread and say how far you are prepared to travel and then tag Jamie, who may be able to suggest someone for you.
Tagging other members and answering tags
 
OP
OP
L

Laskyd

junior member
Joined
Oct 14, 2019
Messages
56
Age
63
Gender
Female
Country
United States United States
Thank you Pumpkin for the very helpful reply and links!! I have read that the dislocation risk is a lot higher in a prior femoral neck fracture patient vs an OA hip patient. This worries me about having posterior approach. However I have had two surgeons who do lots of anterior tell me that they would not do that approach on me because it is too hard to remove the screws.
 
OP
OP
L

Laskyd

junior member
Joined
Oct 14, 2019
Messages
56
Age
63
Gender
Female
Country
United States United States
Wow! Thank you Celle! Those list of questions to ask the surgeon is wonderful!!
I am seeing a surgeon tomorrow and will ask these questions.
I live in zip code 20170 but will go to HSS in New York or somewhere else on East coast if needed to get the best surgeon. Not sure how to access your website to find top surgeons using my zip code
 

Eman85

post-grad
Joined
Mar 4, 2018
Messages
1,542
Age
64
Location
E Tennesee
Gender
Male
Country
United States United States
I cannot tell you anything about a fracture or AVN as I didn't have either. I did have screws in my femor that were in there for 50 years before my THR. There was an attempt made decades ago to remove the screws by a quack DR. so I was greatly concerned before agreeing t THR. My OS was extremely confident about the removal and the THR so I went with him. He does only posterior and approach was no concern for me. I did more reading post op and many OS prefer posterior as it allows them more working room. I went with the surgeon and he chose the approach and hardware. He worked pretty hard to remove the screws and everything worked out fine. As far as dislocation goes I believe it's a risk no matter what and it diminishes over time. The posterior came with restrictions which for me was 6 weeks and then common sense applies after that. The big thing my OS always tells me as I leave his offic is "Don't fall down!".
 
OP
OP
L

Laskyd

junior member
Joined
Oct 14, 2019
Messages
56
Age
63
Gender
Female
Country
United States United States
Eman85. Thank you! That is good tot hear that your surgeon was successful getting screws out. Do you have any permanent restrictions now after your posterior? I love to kayak and garden in my yard.
 

Celle

MODERATOR
Moderator
Joined
Nov 19, 2011
Messages
36,233
Location
New Zealand
Gender
Female
Country
New Zealand New Zealand
Wow! Thank you Celle! Those list of questions to ask the surgeon is wonderful!!
I am seeing a surgeon tomorrow and will ask these questions.
I live in zip code 20170 but will go to HSS in New York or somewhere else on East coast if needed to get the best surgeon. Not sure how to access your website to find top surgeons using my zip code
@Jamie ,
Can you recommend any surgeons who would do a THR on this member, who developed AVN or nonunion after a failed repair of a fractured neck of femur?
 
OP
OP
L

Laskyd

junior member
Joined
Oct 14, 2019
Messages
56
Age
63
Gender
Female
Country
United States United States
@Jamie I have a question about the Surgeon locator. If the surgeon is not listed at all in the locator, is that a red flag for how good the surgeon is? Andy Engh MD in Virginia is VP of the Hip Society but I cannot find him at all.
All the surgeons I do pull up in the Locator for Washington DC, Maryland and Virginia are listed but not rated. Do you have any recommended MDs for my condition and i will go to NY or anywhere else on east coast if needed for a top
Surgeon
 

Eman85

post-grad
Joined
Mar 4, 2018
Messages
1,542
Age
64
Location
E Tennesee
Gender
Male
Country
United States United States
My OS Isn't on the locator.
I can't say I have any permanent restrictions beyond bungee jumping,inversion tables and do not fall down. There are some things common sense which I lack at times tells me not to do. Some things just don't feel right for the first year or so and it's still getting better for me. As my OS put it to me, he did really nice work and I waited all of my life to have this done why do I want to screw it up. I really don't have an urge to do this again, I just want to get this last one over with.
You mention hiking, the goal for this 2nd one is to hike Grandfather Mountain. I would not hesitate to kayak. I garden with no problem. I cut and split wood which we heat with. I've ridden a bicycle and motorcycle since my THR and that picture in my avatar is me.
My OS was quite proud of how he removed my pins/screws. He came to my bedside in recovery to give the the whole play by play of how it went. He fully understood my concern and knew what he was getting in to.
 
OP
OP
L

Laskyd

junior member
Joined
Oct 14, 2019
Messages
56
Age
63
Gender
Female
Country
United States United States
@Jaycey
You mentioned on another thread that you had a more complicated recovery because your hip
collapsed before THR. Did you fully recover? If so how long did it take? Unfortunately I have AVN after femoral neck fracture repair and quickly my hip has collapsed in just 6 months since the fall that caused the fracture. Trying to find a surgeon and it is difficult
 
OP
OP
L

Laskyd

junior member
Joined
Oct 14, 2019
Messages
56
Age
63
Gender
Female
Country
United States United States
@Eman85
So glad to hear from you! That is very reassuring you can do most anything with your new hip. Also reassuring that your great surgeon is not listed either in the locator. I am 63, close to your age, and I also want to hike up Grandfather Mountain. Love your car!
How did you find such a good surgeon? How did you know he was the best? I can’t find one I really like so far.
 

Pumpkln

MODERATOR
Moderator
Joined
Oct 27, 2011
Messages
21,613
Location
United States, West
Gender
Female
Country
United States United States
@Eman85 ,
You can let Jamie know the name and location of your surgeon via a personal message, so they can be added to our Surgeon Locator.
Thanks!
 

Eman85

post-grad
Joined
Mar 4, 2018
Messages
1,542
Age
64
Location
E Tennesee
Gender
Male
Country
United States United States
I was referred to my OS by my GP. I went for an appointment to check him out first. I did find out he had done a friend's complicated THR after that first appointment. I waited a short time and went back to see him again, both times I was asking a lot of questions. I did some other research about the practice and found all positive results. Then I scheduled the surgery. I was very fortunate as it was a good fit and it all worked out. He was very up front about the surgery and the recovery and all they would do to do everything right.
You can do a lot of research but you have to feel comfortable and confident. For me much of it was also good fortune. The OS is just part of it. in my case I was amazed at his staff and also the hospitals where great. The original hospital I had my left done at has closed since then so my right was done at the newer one that replaced the old hospital and the experience there was good also.
Now keep in mind I was in an OS office in 1985 with a replacement hip in my hand. I had plenty of time to think this over and plan it. Unfortunately I know that's not your situation.

There have been others on this board with similar circumstances as yours. Some of the moderators might be able to find some of them for you. Try and do a search.
 
Last edited:
OP
OP
L

Laskyd

junior member
Joined
Oct 14, 2019
Messages
56
Age
63
Gender
Female
Country
United States United States
@Eman85
Who was your surgeon? Yes you are right I don’t have a lot of time. I need surgery by this Jan or Feb latest and I don’t have much time. Hope I don’t end up going to someone who will take me quickly. The good ones are tied up for many months
 
OP
OP
L

Laskyd

junior member
Joined
Oct 14, 2019
Messages
56
Age
63
Gender
Female
Country
United States United States
@Jamie
Have you heard of Dr Brian Evans, chief of Orthopedic Surgery at Georgetown University Hospital in Washington DC? I have THR scheduled for Jan 29 but not sure if I like him.
I scheduled it back in Oct after seeing him once, but now I have important questions to ask him about my surgery and recovery. Unfortunately I cannot get an appt to see him before the surgery. The surgical coordinator said a nurse or PA would get back to me but it has been over a week and no one has. I left a follow up voicemail but nothing yet. Getting frustrated and scared.
 

Jaycey

FORUM ADMINISTRATOR
Administrator
Joined
Jan 27, 2010
Messages
30,402
Location
Yorkshire
Gender
Female
Country
United Kingdom United Kingdom
You mentioned on this thread that you had a more complicated recovery because your hip
collapsed before THR. Did you fully recover? If so how long did it take?
Yes I did fully recover. However it took over one year. It is very hard to break old habits. Months of limping around take their toll on other parts of the body.

I hope you find that surgeon soon.

You will notice I moved your post and my reply to your own thread. This is so we don't hijack another member's thread.
 

Fit4Family

post-grad
Joined
Mar 29, 2019
Messages
1,290
Age
58
Gender
Female
Country
United States United States
Hello @Laskyd

Welcome to BoneSmart.

I fractured my hip too and like you failed the pinning repair. I live in the DC area. You are more than welcome to PM me if you have any questions. I have heard very good things about Dr. Kevin B. Fricka with Anderson Orthopedic Clinic. He did a dear friends hip and she also went to him for both knees.

You are wise to carefully consider each group and hospital. The not for profits in the area seem much better staffed. This year I have been to both Loudoun Hospital and Reston Hospital. Will be at Virginia Hospital Center on 27th. Happy to discuss on PM.

Hoping things come together for you soon. Wishing you a happy, healthy 2020. Sarah
 

Fit4Family

post-grad
Joined
Mar 29, 2019
Messages
1,290
Age
58
Gender
Female
Country
United States United States
@Laskyd

Adding another thought. I was told by my last surgeon that posterior would be easier to remove pins. This will direct all approaches. Leaving femoral bone in best shape to have pin holes filled to ensure your stem will have firm placement. Also how your last surgery was done will impact decision of surgeon.
 
OP
OP
L

Laskyd

junior member
Joined
Oct 14, 2019
Messages
56
Age
63
Gender
Female
Country
United States United States
@Fit4Family
Hi Sarah,
I have seen a lot of surgeons in the DC area and we can compare experiences. Sounds like you are looking too.
This morning I have an appt with Dr Hamilton, an associate with Dr Fricka at Anderson Clinic. I had to wait three months to see him. He is the big anterior guy but now I worry that anterior approach is not ideal for me because of limited visibility in removing the screws.
 
Last edited by a moderator:

BoneSmart #1 Best Blog

Staff online

Forum statistics

Threads
49,637
Messages
1,351,653
BoneSmarties
31,227
Latest member
PepperPott
Recent bookmarks
0

Top Bottom