Dad is all wigged out about having a hip replacement because he has so many other health concerns. He has high blood pressure (though it is controlled with medications). He has high cholesterol (also controlled with meds). And there's his psoriasis and his panic attacks. The list goes on. Do any of these problems come with added risks when having a hip replacement? What can we say to calm him down?

You may want to let his surgeon handle this one. Just asking the question at a pre-op appointment may be all that's needed on your part. If your father has some serious reservations about having the procedure, then it may be best to wait until he is ready for the operation. Sometimes what sounds like complaining is really an inner knowing that the upcoming surgery isn't the right thing to do for that patient.

In answer to your question about risk factors for serious complications following hip replacement surgery, we can tell you the results of a recent study in this area. The surgeons who were involved with the study looked at the percentage of patients who died within the first 90-days following hip replacement. They also assessed how many patients developed serious joint infections during the first 10-years after getting the new hip joint.

They found a very low rate of complications. For a group of 83,000 Medicare patients, there was a one per cent mortality or death rate and a maximum of two percent for infection. The significance of the study was that it did identify the most important risk factors for both infection and death after hip replacement surgery. The patients were tracked for 10 years after the original surgery.

At the top of the list for joint infection was obesity followed by rheumatologic diseases, blood clots, anemia, diabetes, and heart arrhythmias. Risk factors for mortality (death) in the first three months following the procedure were metastatic cancer, congestive heart failure, dementia, and kidney disease. High cholesterol under control was actually linked with a decreased risk of mortality.

Depression and psychoses have a very limited role in complications following hip replacement. Panic attacks were not listed. Psoriasis might fall into the category of rheumatologic diseases but the diagnosis would be psoriatic arthritis, not psoriasis alone. Although your father has some questionable risk factors, his surgeon is really the one to make this judgment call. Encourage him to speak with his doctor and plan the procedure in the best time period given all the considerations.

Reference: 

Jennie McKee. Quantifying the Risks of THA. In AAOS Now. January 2011. Vol. 5. No. 1. Pp. 9-10.

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