John D. Burrow, DO
As a busy Orthopaedic surgeon who specializes in joint replacement, I see patients who need hip replacement for a variety of reasons, but usually due to arthritis or injury. Some of these individuals may have recently been diagnosed with, are in treatment for or are in remission from cancer of all kinds. Thankfully, folks who’ve had cancer often can still utilize hip replacement as a treatment for arthritis. I’m here to offer an orthopaedic perspective and to give you all the facts you need regarding having hip replacement if cancer is or has been a part of your life.
Whether a patient is actively being treated for cancer or in remission comes to see me for a consultation about hip replacement, I will need to discuss the patient’s status with their oncologist. The status of the patient will predicate if and when we move forward with surgery. Until the Oncologist gives me the all-clear, I will help the patient manage painful symptoms with activity modification, Physical Therapy, oral and injectable steroids, and pain medications. I may also recommend alternative treatments such as acupuncture, massage, aqua therapy or yoga to help manage discomfort until we can move forward with surgery.
If the patient has active cancer and is in treatment, hip replacement surgery will need to be delayed. Why? Because 1) any surgical procedure performed will be reserved for removing/treating the cancer itself; 2) the chemotherapy and radiation used to fight the cancer is extremely hard on the body; 3) chemotherapy drugs reduce white blood cell count making the patient much more prone to infection; 4) radiation, which may be targeted at the lower spine, pelvis, or femur, female or male reproductive organs, colon, etc., may cause osteoporosis or osteopenia in the bones of the femur and pelvis, which may need to be treated before surgery or planned for appropriately during surgery.
Even when the patient’s cancer treatment has ended and they are considered in remission, they go through a recuperation period while their body is healing from the cancer treatments they received. A rule of thumb is one month of recovery for every two months of treatment, which is longer than most folks expect. During this time, white and red blood cell counts need to return to normal and blood chemistry levels need to regulate as there will be many waste products that need to be cleansed from the blood after treatment. Patients may have extreme fatigue, muscle wasting and weight loss after chemotherapy, and will need time to nourish their bodies and rebuild strength lost during treatment. The patient should give themselves adequate time to feel better physically, emotionally, and spiritually.
Once the patient has recovered and is medically cleared by their Oncologist, we can discuss moving forward with the surgery. If the Oncologist has not already done so, I will order a Bone Density scan for the patient to ascertain if their cancer treatment has negatively impacted their bone health. If so, I will plan to use implants made specifically for patients who have bone loss and taken special care during surgery to avoid the fractures for which these patients are typically at risk, as well as loosening of the implant. A successful outcome from hip replacement surgery is my main goal for you, my patient. Working in partnership with your Oncologist, we can achieve that goal together.
Make an appointment with Dr. Burrow or another OSC provider by clicking the “Request Appointment” button below or by calling (757) 596-1900.