I'm planning to have a joint resurfacing done to my right hip next month. The surgeon has warned me that hip fracture is a possible complication of this procedure. Is there anything I can do to keep this from happening?

Good nutrition is always advised to maintain the best health possible before having surgery of any kind. Eliminating or reducing the use of tobacco products is known to improve wound healing after any operation.

In the case of hip fracture after joint resurfacing, there may be some biologic factors at play. A recent study in England showed a decreased amount of oxygen to the femoral head during the operation.

The change in oxygen level was observed when the surgeon cut the hip muscles and joint capsule. They do this before removing (dislocating) the femoral head. When the hip was relocated, the oxygen supply was not restored. The blood supply does eventually come back. It takes about 90 days.

Hip fracture is more likely during this three-month period without blood and oxygen, a condition called ischemia. The risk of osteonecrosis (death of bone) and fracture is also much greater during this time.

There isn't anything you can do as a patient about the ischemia. More studies are needed to find ways to prevent this problem from occuring during this operation.

Reference: 

Peter McLardy-Smith, FRCS, et al. Metal-on-Metal Hip Resurfacing: America, Where Are You? In Orthopedics. September 2006. Vol. 29. No. 9. Pp. 795-796.

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