March 8, 2021

How to reduce your risk after hip surgery

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Recovering from hip surgery can take its toll, but new measures exist to keep you safe and healthy.

Hip fractures in elderly patients are all too common — and, unfortunately, the surgery required to repair these injuries can be followed by complications. If you suffer a fall and are in the hospital over a long period of time, you could experience urinary tract infections, blood clots, pneumonia, bed sores, etc. That’s why, especially if you’re of advanced age and are medically frail, time is of the essence.

Luckily, many providers, like Vanderbilt University Medical Center’s Orthopaedic Trauma division, are taking measures to streamline care, improve pain control, and reduce time spent in the hospital following hip fracture surgery.

“That’s a big component of what we’re trying to do,” said Phillip M. Mitchell, M.D., assistant professor, Orthopaedic Surgery, Division of Orthopaedic Trauma; and director of Medical Student Education, Orthopaedic Surgery Resident Program. “We want to make sure that once a patient’s surgery is done, their postoperative care is streamlined, allowing for an early mobilization and discharge to either a rehab center or back home for their hip surgery recovery.”

Here are some of the protocols being followed — and why they matter for hip fracture patients.

Optimizing Care

“As soon as they hit the door we’re notified, as is our anesthesia team, which sets in motion a series of steps to optimize their care.”

When patients arrive at the emergency department, “as soon as they hit the door we’re notified,” said Mitchell, “as is our anesthesia team, which sets in motion a series of steps to optimize their care.”

The anesthesia provider will see the patient and provide a nerve block in the Emergency Department to help with pain, decreasing the need for opioids and the complications these medications can cause. Simultaneously, patients are put on the orthopaedic team’s radar, which also places them on the physical therapy and case management lists.

“As soon as surgery is done,” said Mitchell, “they’ve already started to move through the pipeline, from getting early referrals in for rehab to working with therapy to know what equipment they’re going to need at home. All of those steps are done as quickly and efficiently as possible.”

A Quicker Road to Hip Surgery Recovery

Surgery almost always takes place first thing in the morning, often with a spinal anesthetic instead of general anesthesia, which allows patients to begin their hip surgery recovery immediately.

“They can get out of surgery and to the floor to begin recovering,” Mitchell said, “because we know that even a half-day saved with these patients can pay dividends down the line.”

After surgery, the team uses a pain regimen that minimizes narcotic use. Almost immediately, a priority is getting the patient to start putting weight on the leg. Physical therapists work with patients to encourage and emphasize early mobilization, as movement is the best way to ensure a safe and effective hip surgery recovery.

“The physical therapy team works with these patients on a daily basis. And they’re absolutely excellent when it comes to taking care of them in a safe manner,” Mitchell said. “So, whether the patient is going home or to a rehab facility, one of the primary jobs of the physical therapist is to assess what needs to be in place to make sure that patients are safe and don’t have another fall, especially as they are recovering and building back strength.”

If indicated, endocrinologists who specialize in bone health will also become a part of the treatment team to ensure that the patient not only recovers from this fracture, but also is in a better bone health position to decrease the risk of future fractures.

Full hip surgery recovery tends to take around two to three months, at which time patients start to wean off their walker or cane.

“What differentiates our approach to the care of fractures occurring in our senior population is that we understand the that the long-term impact of a broken hip, for instance, can be devastating to the independence of our older patients, and that the injury is more than just a broken bone,” Mitchell said. “We approach geriatric fractures with a full-court press of experts who understand the issues unique to older patients.”

fall prevention tips

Making the Call

Make an appointment to see one of Vanderbilt’s six fellowship-trained orthopaedic trauma specialist by calling 615-936-7846 or ask the EMS team to bring you to Vanderbilt University Medical Center.

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