Dr Rahul Sharma is a senior orthopedic surgeon and did his prestigious AOA Australian Orthopaedic Association fellowship from Sydney (Australia). He spent some time in Rothman Hospital in Philadelphia (USA).
There was a time when old people particularly those nearing 100 years of age were left to depend on others for the rest of their lives or fend for themselves – without any treatment and had no option but to live with agonizing and unbearable pain due to blood loss, blood clots, bed sores and other complications after falls and fractures – a fairly common occurrence in old age. Not anymore, due to the latest advancements in medical science.
Significantly almost 50% of women and 20% of men over the age of 50 have osteoporosis, which is a significant risk factor for hip bone fractures in older adults in India. It’s estimated that by 2026, the number of hip fractures in India will increase significantly, with around 600,000 osteoporotic hip fractures occurring annually.
According to studies hip bone fractures are the cause behind 15% to 36% mortality rates. A study published in the Journal of Clinical Orthopaedics and Trauma revealed that the overall 2-year mortality rate for hip fracture patients in India is around 11.2%. Many older adults in India face significant barriers to accessing timely and adequate healthcare for hip fractures, including limited availability of orthopedic services and rehabilitation facilities. Hence, there is a need for standardized, effective, and multidisciplinary management approaches for the treatment and rehabilitation of hip fracture patients in India.
According to Dr Rahul Sharma, a senior orthopaedic surgeon, “A hip fracture can be a complex and dangerous problem for people who are older than 65 years of age. They can’t stand, walk or put weight on a broken hip. They also cannot prevent hip bone fractures due to sudden falls or other trauma because they can’t plan the cause behind them. It usually takes at least a few months and at times a year after treatment to notice improvements and fully recover from a broken hip depending upon factors like the age of the patient, his/her overall health, what caused the fracture, the type of surgery performed, and other injuries suffered”.
“Any health condition that affects the balance, stability, or ability to walk can increase the risk of breaking a hip. The older you are, the longer it takes your body to heal any injury, and that’s especially true when you have a major hip fracture. The surgery to treat a hip fracture and recovery from it is much harder in the case of older adults”, he says.
“The risk of falls and fractures is even more profound in older adults, particularly those nearing 100 years of age who are more susceptible and have a higher risk of falls, fractures, and injuries due to age-related reduced mobility, balance, and strength, osteoporosis, dementia, cognitive impairment, reduced vision, hearing, and sensory perception as well as chronic conditions like diabetes, hypertension, and cardiovascular disease”, he adds.
Even extrinsic factors like slippery floors, uneven surfaces, poor lighting and footwear with slippery soles or poor traction as well as medications that cause dizziness, and drowsiness can increase the risk of falls.
As a result, falls and fractures lead to loss of independence, decline in mobility, chronic pain, life-threatening conditions, and reduced quality of life. Hip fractures not only drastically affect the older adult’s quality of life but also that of their caregivers, leading to financial burdens and increased care requirements. Hip fractures impose a significant
economic burden on individuals, families, and the healthcare system in India. Many older adults in
India faces challenges in accessing timely and appropriate healthcare for hip fractures. According to a study published in the Journal of Clinical Orthopaedics and Trauma, only 16.1% of centenarian patients were able to walk outdoors one year after surgery, while 83.9% had to stay indoors.
Hip fractures in older adults are a significant public health concern in India, with far-reaching consequences for individuals, families, and the healthcare system. As per another estimate, 1 in 3 women and 1 in 5 men above the age of 50 will experience osteoporotic fractures in their lifetime. In the years to come, the number of patients with hip fractures in India is expected to rise due to the growing population of aging people, and women in particular are more likely to experience hip fractures than men.
As a result, older adults nearing 100 years of age require prompt and effective management of hip fractures to minimize the mortality rate and improve the quality of life. Hip replacements are usually safe surgeries which usually take one to two hours. Most people regain their mobility as well as range of motion and experience a dramatic decrease in pain and stiffness after a hip replacement. A hip replacement usually makes it easier to walk, climb stairs, and do other physical activities. If all goes well, a patient may be able to use the hip, walk, move, sit down, stand up, go up or down the stairs, go to the washroom, bathe, shower, and get dressed without any restrictions in six to 12 weeks. During a hip replacement, the surgeon removes a part of the bone and cartilage from the existing hip joint and replaces it with a prosthesis usually made of metal, plastic, or ceramic.
A living example is S C Kapur, a 100-year-old man who suffered a medical emergency and acute unbearable pain due to a major hip joint fracture after a fall in his house. He was admitted to the hospital where Dr Rahul Sharma a senior orthopaedic surgeon and joint replacement expert advised him an immediate and elective hip bone replacement surgery which was the only solution for his type of fracture, and associated comorbidities.
It was not an easy decision, and a multidisciplinary team of orthopedic surgeons, anesthetists, physicians, cardiologists, and intensive care specialists were required to care for the patient during the surgery. It seemed to be a big and challenging task considering the patient’s age and precarious medical condition, but Dr Rahul Sharma and his team accepted the challenge and successfully performed the complex hip arthroplasty surgery (joint replacement surgery) which lasted nearly 90 minutes. The surgery was done with the highest standards of asepsis to prevent infection.
After the meticulous surgery, the patient was discharged from the hospital after about 3 days. He is now undergoing rehabilitation and can walk comfortably. According to Dr Rahul Sharma an expert in hip, knee, and shoulder surgeries and founder of Life in Motion Clinic who practices in Sawan Neelu Angel’s Hospital, Saket, New Delhi, “A successful surgery with good outcomes not only gives satisfaction to the medical team but also installs the faith in the patient over medical advancements. The geriatric population of our society is the most sensitive class that needs and deserves a better medical care facility to achieve a better life.
This story is a testament to the tireless efforts of doctors who constantly work for the betterment of their patients and strive to give them a better lifestyle without the fear of surgery that makes them lead a miserable life dependent on others.