Reviewed by Shirdi Sai Hospital Team
Severe hip arthritis can make walking, climbing stairs, sitting, standing, and routine daily activities difficult. When hip pain continues for years and does not improve with conservative care, total hip replacement may be considered after orthopedic evaluation. In some complex cases, additional surgical care may be required if a fracture occurs around the hip implant.
This case study explains how an elderly patient with severe left hip osteoarthritis was evaluated and treated at Shirdi Sai Hospital, New BEL Road. The patient underwent left total hip replacement and later required fracture fixation for a periprosthetic femur fracture. The case is shared for awareness only. Patient identity and personal details have been fully removed for privacy.
Case Summary
An elderly female patient came to Shirdi Sai Hospital with severe left hip pain and difficulty walking. The pain had been present for several years and had worsened over time. The patient was unable to walk comfortably, climb stairs, or perform routine activities without significant difficulty.
The patient had already been evaluated for bilateral hip osteoarthritis and had previously undergone right hip replacement. This admission was for management of severe left hip osteoarthritis.
After evaluation by the Orthopedics team, the patient underwent left total hip replacement. A post-operative X-ray later showed a periprosthetic fracture of the left femur. The patient then underwent open reduction and internal fixation using a proximal femur plate and stainless steel wire. The post-operative course was stable, and the patient was discharged with medicines, physiotherapy advice, walking guidance, catheter removal advice, and follow-up instructions.
What Was the Patient’s Main Problem?
The patient’s main problem was long-standing severe pain in the left hip. The pain affected basic movement and daily activity.
The patient had difficulty with:
- walking
- climbing stairs
- doing routine activities
- standing or moving comfortably
- maintaining normal mobility
Long-standing hip pain can reduce independence, confidence, and quality of life, especially in elderly patients. When hip arthritis becomes advanced, patients may avoid walking due to pain, which can further reduce muscle strength and mobility.
Final Diagnosis
The final diagnosis included:
- left hip osteoarthritis
- left femur periprosthetic fracture
- previous right hip replacement in situ
This means the patient had severe arthritis of the left hip and later developed a fracture around the femur near the hip replacement implant. The right hip replacement had already been done earlier and was present at the time of admission.
What Is Hip Osteoarthritis?
Hip osteoarthritis is a degenerative joint condition where the cartilage covering the hip joint gradually wears down. As cartilage reduces, the bones may rub against each other, causing pain, stiffness, reduced movement, and difficulty walking.
Common symptoms of hip osteoarthritis include:
- groin pain
- hip pain
- thigh pain
- stiffness after rest
- difficulty walking
- difficulty climbing stairs
- difficulty sitting cross-legged
- pain while standing from a chair
- reduced hip movement
- limp while walking
- sleep disturbance due to pain in some patients
Hip osteoarthritis usually progresses gradually. In early stages, medicines, exercise, weight control, walking support, and physiotherapy may help. In advanced stages, when pain and disability become severe, surgical treatment may be considered.
Patients with hip pain, knee pain, fractures, arthritis, sports injuries, or mobility problems can consult the Orthopedics department at Shirdi Sai Hospital for evaluation.
When Is Hip Replacement Considered?
Hip replacement is considered when arthritis has severely damaged the hip joint and symptoms are affecting daily life despite conservative care.
It may be discussed when the patient has:
- severe hip pain
- difficulty walking
- difficulty climbing stairs
- reduced range of hip movement
- pain not improving with medicines or physiotherapy
- X-ray evidence of advanced hip arthritis
- inability to perform routine activities
- poor quality of life due to hip pain
Hip replacement is not advised only because an X-ray shows arthritis. The decision is based on symptoms, functional limitation, imaging findings, age, medical condition, and patient-specific goals.
Treatment Approach at Shirdi Sai Hospital
The patient was admitted under orthopedic care. The treatment process included:
- orthopedic evaluation
- clinical examination
- relevant investigations
- review of reports
- surgical consent
- left total hip replacement
- post-operative monitoring
- post-operative X-ray assessment
- blood transfusion support when required
- second surgery for fracture fixation
- antibiotics and supportive medicines
- pain management
- physiotherapy
- walker-assisted mobilisation
- discharge planning
- follow-up advice
The care plan was based on the patient’s condition, diagnosis, operative findings, and recovery status.
What Is Total Hip Replacement?
Total hip replacement, also called total hip arthroplasty, is a surgery where the damaged parts of the hip joint are replaced with artificial components. It is commonly done for advanced hip arthritis when pain and stiffness affect mobility.
The goal of hip replacement is to:
- reduce arthritis-related hip pain
- improve hip function
- help the patient walk better
- improve daily activity ability
- support better mobility when recovery is complete
Recovery after hip replacement requires physiotherapy, walking support, wound care, fall prevention, and follow-up visits.
What Is a Hybrid Hip Replacement?
A hybrid hip replacement is a type of hip replacement where the surgeon uses a combination of fixation methods for the implant components. The exact implant choice depends on bone quality, patient age, surgeon assessment, and intraoperative decision-making.
In this case, the patient underwent left total hip replacement using a hybrid approach. The choice of technique was made by the treating orthopedic team based on clinical judgment.
What Is a Periprosthetic Femur Fracture?
A periprosthetic femur fracture is a fracture that occurs around or near a hip replacement implant. It is a known orthopedic complication and needs careful evaluation because treatment depends on the fracture location, implant stability, bone quality, and patient condition.
A periprosthetic fracture may require:
- observation in selected stable cases
- fixation using plate, screws, cables, or wires
- revision hip surgery in selected cases
- restricted or guided weight bearing
- physiotherapy
- close follow-up
In this case, the post-operative X-ray showed a left femur periprosthetic fracture. The patient underwent open reduction and internal fixation with a proximal femur plate and stainless steel wire.
What Is ORIF with Plate and Wire?
ORIF means Open Reduction and Internal Fixation.
- Open reduction means the fracture is surgically exposed and aligned.
- Internal fixation means implants are used to hold the bone in position while it heals.
In this case, the fracture was fixed using a proximal femur plate and stainless steel wire. This helped stabilize the fracture around the hip replacement area.
ORIF is planned based on fracture pattern, bone quality, implant position, and patient safety.
Why Was a Second Surgery Needed?
A second surgery was needed because a periprosthetic fracture was identified after hip replacement. Such fractures need proper stabilization when the fracture pattern and clinical condition require it.
The goal of the second surgery was to:
- align the fractured femur
- stabilize the bone
- protect the hip replacement area
- support recovery and mobility planning
- reduce the risk of poor fracture healing
The patient underwent ORIF with proximal femur plate and stainless steel wire. The operative and post-operative course was documented as stable.
Hospital Course and Recovery
After the hip replacement surgery, the patient was shifted for monitoring. Post-operative orders were followed, vitals were monitored, and imaging was reviewed.
After the periprosthetic fracture was identified, the patient underwent fracture fixation surgery. The patient was later shifted for ward observation once stable.
The recovery plan included:
- post-operative monitoring
- antibiotics and supportive medicines
- pain control
- blood transfusion support when required
- wound dressing
- physiotherapy
- walker-assisted mobilisation
- discharge medicines
- follow-up review
- catheter removal advice
At discharge, the patient was documented as hemodynamically stable.
Physiotherapy After Hip Replacement and Fracture Fixation
Physiotherapy is a key part of recovery after hip replacement and fracture fixation. Surgery stabilizes the joint and bone, but movement, strength, balance, and walking confidence need guided rehabilitation.
Physiotherapy may help with:
- safe movement training
- strengthening exercises
- walking with support
- fall prevention
- reducing stiffness
- improving confidence
- protecting the operated limb
- gradual return to daily activities
Patients should follow the treating doctor and physiotherapist’s instructions about walking, weight-bearing, exercises, and movement restrictions. These instructions can differ from patient to patient.
Warning Signs After Hip Replacement or Fracture Fixation
The discharge advice included immediate reporting if persistent fever or pus at the operated site occurs.
Patients should seek urgent review if they notice:
- persistent fever
- pus discharge from wound
- wound redness
- wound swelling
- severe pain
- increasing hip or thigh swelling
- bleeding from wound
- calf pain or swelling
- breathing difficulty
- sudden inability to move the operated limb
- fall after surgery
- sudden worsening of pain
- catheter-related discomfort, blockage, or reduced urine output
Post-operative symptoms should not be ignored, especially in elderly patients.
What This Case Teaches Patients About Hip Arthritis
This case highlights an important lesson: long-standing hip pain should not be ignored when it starts affecting walking, stairs, and daily routine.
Key learnings include:
- Severe hip arthritis can affect independence.
- Difficulty walking and climbing stairs needs orthopedic evaluation.
- Hip replacement may be considered in advanced arthritis when symptoms are severe.
- Periprosthetic fracture is a serious complication that needs specialist management.
- Recovery after hip surgery needs physiotherapy and follow-up.
- Elderly patients need careful post-operative monitoring.
- Treatment decisions vary from patient to patient.
Hip Arthritis vs Normal Age-Related Hip Pain
| Symptom Pattern | More Likely Age-Related Stiffness | More Concerning for Hip Arthritis |
|---|---|---|
| Mild stiffness after rest | Common | Can occur |
| Severe pain while walking | Less typical | Common in advanced cases |
| Difficulty climbing stairs | May occur mildly | Common when arthritis progresses |
| Pain for years | Needs evaluation | Strong concern |
| Reduced hip movement | Less typical | Common |
| Limp while walking | Not normal | Needs evaluation |
| Inability to do routine work | Not normal | Needs orthopedic care |
| X-ray showing joint damage | Not assessed clinically | Supports diagnosis when symptoms match |
This table is for awareness only. Diagnosis requires clinical examination and imaging.
Shirdi Sai Hospital and Sathya Sai Hospital Are Different
Some patients searching online may confuse Shirdi Sai Hospital with Sathya Sai Hospital because the names sound similar. They are not the same hospital.
This case study refers to Shirdi Sai Hospital Pvt. Ltd., located at No. 519, 2nd Main, Nethravathi Street, Devasandra, New BEL Road, Bangalore – 560054.
Before visiting, patients should confirm the hospital name, location, phone number, and official website. For this case study and related orthopedic care, the correct hospital is Shirdi Sai Hospital on New BEL Road.
Patients can visit the official Shirdi Sai Hospital website for hospital information and appointments.
Why Patients Choose Shirdi Sai Hospital for Hip and Fracture Care
At Shirdi Sai Hospital, New BEL Road, orthopedic symptoms such as hip pain, knee pain, fractures, arthritis, sports injuries, and mobility problems are evaluated through the Orthopedics department. In complex cases, a multispeciality hospital setting can also support medical evaluation, post-operative monitoring, transfusion support when required, physiotherapy, and follow-up care.
Patients may choose Shirdi Sai Hospital because:
- orthopedic care is available on New BEL Road
- hip arthritis and fracture-related symptoms are evaluated clinically
- imaging and surgical planning are guided by orthopedic assessment
- hip replacement and fracture fixation may be considered where clinically suitable
- post-operative monitoring and physiotherapy guidance support recovery
- emergency and multispeciality support are available when needed
- the hospital is accessible for patients from Devasandra, Mathikere, RMV 2nd Stage, Sanjaynagar, Hebbal, and nearby areas
Patients with severe hip pain, difficulty walking, suspected fracture, arthritis symptoms, or previous joint replacement concerns can consult the Orthopedics department at Shirdi Sai Hospital for evaluation.
Patient Privacy Note
This case study has been written with patient identity removed. Personal identifiers such as name, registration number, address, exact admission date, discharge date, and identifying personal details have not been included.
The purpose of this case study is patient education and awareness. Treatment decisions vary from patient to patient. A similar diagnosis does not mean every patient will need the same surgery, medicines, hospital stay, walking plan, catheter support, or rehabilitation protocol.
Frequently Asked Questions
What is hip osteoarthritis?
Hip osteoarthritis is a degenerative condition where the cartilage in the hip joint wears down, leading to pain, stiffness, reduced movement, difficulty walking, and trouble climbing stairs.
When is hip replacement needed?
Hip replacement may be considered when hip arthritis causes severe pain, walking difficulty, reduced movement, and poor daily function despite non-surgical treatment.
What is a periprosthetic femur fracture?
A periprosthetic femur fracture is a fracture that occurs around or near a hip replacement implant. It needs orthopedic evaluation because treatment depends on fracture pattern and implant stability.
What is ORIF in fracture treatment?
ORIF means Open Reduction and Internal Fixation. It is a surgery where the fracture is aligned and stabilized using implants such as plates, screws, rods, wires, or other fixation devices.
Is physiotherapy needed after hip replacement?
Yes. Physiotherapy helps with safe walking, strengthening, movement recovery, stiffness reduction, and fall prevention after hip replacement.
What warning signs need review after hip surgery?
Persistent fever, pus discharge, wound redness, severe pain, sudden swelling, breathing difficulty, fall after surgery, or sudden worsening of movement should be reviewed urgently.
Is every hip arthritis patient treated with surgery?
No. Treatment depends on severity, pain level, X-ray findings, function, age, health condition, and response to non-surgical care. Surgery is considered when symptoms are advanced and disabling.
Conclusion
This case shows how severe left hip osteoarthritis affecting walking, stair climbing, and routine activity was treated surgically at Shirdi Sai Hospital, New BEL Road. The patient underwent left total hip replacement and later required ORIF with proximal femur plate and stainless steel wire for a periprosthetic femur fracture. The patient was monitored, supported with medicines, mobilized with guidance, and discharged in stable condition with follow-up advice.
Long-standing hip pain should not be ignored when it starts affecting daily life. Early orthopedic evaluation helps patients understand whether medicines, physiotherapy, walking support, hip replacement, fracture fixation, or another treatment plan is suitable.
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