THR (Total hip replacement) after Perthes Caution

Hi,

The reason for this post is a word of caution to ensure that you won't encounter the same experience dealing with life after perthes as I have just gone through.

A bit of background:-

I'm 49, 6' tall, weigh 88kg and just undergone a right THR.

I was diagnosed with perthes in right hip when I was 3 and was on crutches for 2 years to ensure non weight bearing on right leg. Hip over the years has taken some hard abuse including running and rugby so steadily it has became more and more painful. This year x-rays showed bone on bone rubbing in hip joint so I decided it was time to have the THR as it was badly affecting my daily life.

I was lucky enough to have a very experienced surgeon who does many hip replacements every week to carry out the surgery.

THR operations and fracture:-

The THR Surgery had gone well according to the consultant but when I was walking that evening after the Op in the ward I suffered a femur fracture.

I didn't fall, I was using 2 x sticks, and I was with a physio. After 20m walking I suddenly couldn't put any weight on my right leg. Fracture occurred on groin side (inside) of femur where taper uncemented stem entered the newly cut femur. Fracture resulted in Femur sliding up outside of pelvis so my right leg was approx 1.5" shorter than my left leg.

Next day I was back in theatre for revision surgery and I now have cemented stem and wires for fracture. Revision surgery should have been 20 years + not within 24 hours.

Now the reason for the post:-

I don't want anybody to have to go though this so please, if you have had perthes, to ensure the surgeon checks properly the femur bone thickness and carefully considers if using a taper uncemented stem is really the right thing for you. It might be, and I'm sure everybody is different, but just ask the surgeon to make sure please as even with a very experienced surgeon they might not fully understand the extent, or implications, of having perthes many years before.

I was lucky in a way it happened then with the right people there but I think it could have been avoided in hindsight and I kick myself as I should have asked the question and should have discussed it more detail.

I'm now in my 5th week and doing well.

Thank you for reading.

John

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