New hip at 90...?

[CosyBungalow]

My 90yr old mum has Osteoporosis. She's been dealing with hip pain for quite a few years. With the Osteoporosis diagnosis came an appt with an Orthopedic Surgeon, who said he would be happy to do a hip replacement - the wait time is approx 10mths.
She lives alone, in a bungalow, with me close by. She is in good health, other than the Osteoporosis, and has no cognitive concerns.
She's concerned about the recovery, and if she would actually benefit long term from having a hip replacement.
We dont know anyone who's had a new hip, so no one really we can ask about recovery.

That seems insane to me would she even survive the surgery and anesthetic. Surgery puts a massive strain on the body

The queen mum had one at 95!

If the anaesthetist is happy and she is in such severe discomfort she wants to go ahead and is prepared for the recovery, I would also be happy.

The consultant we saw has asked that she keep a pain diary for 6 weeks, and has made us an appt for 6 weeks time.
I think she's sort of learned to live with the pain.
The anesthetic is my worry. She did have a full hysterectomy aged 86, to remove a large ovarian cyst, and recovered well from that.
She is undecided at the moment, so I was hoping someone might have had a parent who had a hip replacement later in life

My dm had a hip replacement in her later 80s with epidural rather than anaesthetic because of risks. She did recover well. Could that be an option?

She is in good health and could live another 10 years. Hip replacement are often done under an epidural and patients in their 90s tend to have good outcomes particularly if they are in good health to begin with. Age alone should never be a barrier to surgery that would drastically improve quality of life.

My mum had one at 85 after a fall and being on the floor for 2.5 days before I found her. So she was in a terrible condition when she had the surgery. The first few days were touch and go because of this. But she recovered and got back to walking independently (and still doesn’t need a stick or walker at 90).

My neighbour had a knee replacement (so slightly different) aged 91, originally epidural but had to convert to a GA. Following the surgery she never got back on her feet as well as she did before the pain has not gone because she has different pain and swelling due in part to immobility. Its a viscous circle but even with physio has not progressed much. Thats not to say thats what will happen to your dm but your mum needs to know the statistics for her age group and the potential worst case scenarios.

Depends on her fraility score and general health.

I would.do my own research and want a compelling reason / to feel assured of a good outcome.

Caveat: I am once bitten twice shy dont take surgeons at face value
i had cardiac surgery thst was "simple" and "routine," that lost me a year of my life most of my hair and 3 surgeries in i am "sicker," than I was presurgery.

My very fit 84 year old MIL had a fall and had an emergency hip replacement. The operation went well, she was home in 3 days. It really knocked her confidence, she needed help with stairs and relied on a walking stick for months, even though she was past needing it. It was hard seeing her struggle and sitting down for long periods, when before we couldn’t get her to ease up.

From what I've read knee replacements are more problematic after the initial recovery - I know a few people who have had new knees and wish they hadn't bothered.
She's aware of possible issues around recovery, and I guess as everyone is different, and responds differently to surgery, then the decision has to be hers. I think reading back on the pain diary will be helpful to see how bad the pain gets, and if it is like that most of the time.
I think my worry is that with the osteoporosis, I wonder if a serious fall will come sooner rather than later, and a new hip not then be possible - but I will support my mums decision, what ever she decides to do

My grandma just had her hip replaced, she’s 90 this year. She’s similar to your mum in that she is in otherwise good health / no cognitive concerns. She had it just after Christmas and went into a home for 3 weeks after. She’s back at home now and back to her usual self. She said since the operation she has been in no pain at all. I did wonder if it would be the end of her but she has a complete new lease of life

I used to work in a nursing home and the hip replacements we saw in patients were often results of emergencies rather than routine (following falls). And few had good outcomes. If she has pain in other joints other than her hips, I would question the value of such a risk.

If she's in pain, it's probably a good idea.
But the op is only part if the process..... will she put in the work, do the physio and all her exercises? If not, then don't bother with surgery.
She'll also need some tough love from the family..... no fetching and carrying, no waiting on her, because she'll be told to get moving ASAP!
If there are potential anaesthetic issues, they will be picked up at a pre-op assessment.

My great aunt had this at a slightly younger age and regretted it, as it didn't bring the results she wanted. To be honest she declined since having it. Obviously this is only one story though, and the only person I know to have had one around that age.

My grandma had a new hip after a fall at the same age. She’s doing brilliantly.

My DiL's grandma had a hip replacement at 91 last year. She recovered well and is fine.

My FiL had hip replacement surgery in his late 80’s. The op was awful, all sorts of complications. It took him nearly a year to fully recover, BUT, the pain he had been living with for years vanished instantly, and he’s now back to being able to walk several miles a day, play bowls and golf again. So, for him, it was really worth it

MiL had a second one done in her mid eighties, her first one having been done in her sixties, which was perfect. The second one was a disaster. She never really healed and spent her last couple of years with sores, swelling, and bandages on her legs, in awful pain.

They wouldn't have suggested it if it was more dangerous than beneficial. As you say she's in good enough health otherwise.

It will of course be a good thing for her. She needs to do her physio so if you want to be supportive you could help her with that.

Of course there's risks but they are balanced with positives. The surgeon wouldn't operate on someone that medically was too frail.

The aunt of a friend had hers replaced when she was 102, this was on the NHS not private - she was in really good health and they figured correctly that she was ok for recovery.
Conversely another woman I know had hers replaced in her early 70s and never walked properly again - it's not about age, it's about that specific person.

If the experts have recommended it, they must be pretty confident that she will benefit from it.

My grandfather had a hip replacement done at 95 after a fall. Not having it would have left him immobile. He recovered fine and lived fairly mobile for another 5 years.
If she is generally healthy then I would take what is being offered. They wouldn’t offer they thought it was a bad ideas.

My mother had a hip replacement at 83. She had no choice because she fell and broke her hip! She recovered very well from it, despite having mid-stage dementia.

However, she was living in a care home who very conscientiously did the daily rehab with her, and were able to get her to progress from using a wheelchair and rollator to walking unassisted within a month.

It is very unlikely your mother would have that level of care in her own home, so if she does go ahead I would (if possible) book her into a care home who can take care of her and rehab her for a fortnight.

My Dad had a new hip last week. He's 90 and it was following a fall. He's doing well with getting moving, and I'm hoping it will help with his overall mobility.

anaesthetist pov... it's not that uncommon to be doing hips in 90 yr olds... but it is major surgery and comes with some risks. It is sometimes useful to see an anaesthetist in a pre-op clinic to go through the potential pitfalls (the surgeons are great at the bones/mechanics...we're probably better at looking at everything else). There is often a risk of functional decline even if everything goes smoothly, but that may be an acceptable trade if the pain/instability is bad enough.

The most common type of anaesthetic used for hips is a spinal injection (not an epidural), ideally with no/very light sedation, and there may be real advantage in terms of post op cognition so long as there isn't a medical contraindication to a spinal. You also cannot compare elective hip replacements with those done after hip fractures... it's a completely different ball game (even if the operation is more or less the same). Ditto for knees... completely different kettle of fish.
A reasonably fit 90 yr old is often in much better condition than a 70 yr old with a bunch of medical problems - you do have to be in pretty good nick to make it to 90 and they're often surprisingly robust!

DH’s granny has had both replaced. The first after a fall when she was 89. The second planned, when she started to have high pain and was concerned about another fall, when she was 91. Her only regret is not doing the first one sooner.

shes 104 and has only recently relented to using a walker frame (I don’t believe for a second she uses it when nobody is looking).