Case Study: Successful Surgery Of Hip Fracture Led By Knee Arthritis

The existing scientific literature has shown an increased risk of hip fractures due to knee arthritis in elderly patients.

Patient Quote Krishnakumari Pabreja (83), a resident of Juhu, said, "For over a decade, I have been suffering from knee arthritis,, and many doctors advised me to undergo knee replacement surgery, but I avoided it. I fractured my hip when I went for a walk outside my house and had a fall. I had to undergo an an operation for the fracture and am recovering from the same."

Patient Details: An 83-year-old woman has suffered knee arthritis for ten years.

• She did not undergo knee replacement surgery due to fear of operation and also as her relatives asked her to avoid undergoing surgery.
• Due to the disease, she suffers from extreme pain.
• The disease led to her legs deforming as they were in a v-shape.
• On November 16, she fell while she had gone for a walk outside her house.
• This incident led to a hip fracture, for which she was operated on November 18.
• She is from a well-to-do family, stays in Juhu and is recovering from the fracture.

Doctor's observations on the patient and trend seen in arthritis patients: The patient has had advanced knee arthritis with deformity on both sides and was advised knee replacement surgery by many doctors, but she did not undergo surgery.

• She got operated on for the hip fracture and is recovering well.
• Patients tend not to operate on knee arthritis, leading to hip fractures.
• If the hip fracture is not treated in time, it can be fatal, and the person can die in a year.

Dr Siddharth Shah, Consultant Orthopaedics & Joint Replacement Surgeon, S L Raheja Hospital, on the surgery complications

How complicated was the surgery?

• The surgery's complexity directly depends on the pattern and severity of the fractured bone. Often, the hip joint ball must be replaced. If the bone is shattered, it must be carefully reconstructed.
• For example, our patient required the replacement of the hip joint ball and reconstruction of the surrounding bone and tendon.
• Also, the risk involved in the surgery is high due to the advanced age of the patient and her existing medical comorbidities.
• Lastly, postoperative rehabilitation, like walking, becomes very difficult due to the pre-existing knee pain and deformity caused by knee arthritis.

If the patient had comorbidities due to which surgery was complicated?

Yes, due to all the above factors.

The existing scientific literature has shown an increased risk of hip fractures due to knee arthritis in elderly patients. However, whether younger patients with knee arthritis have an increased risk of hip fractures is unknown.