PIG Meeting: 18th February 2021
- Elderly man seen in perioperative clinic for THR.
- Requiring arthroplasty to both hips.
- Longstanding severe OA. Now wheelchair bound and sleeping in a chair
- Significant bilateral peripheral oedema both legs, likely due to inability to mobilise/raise legs
- Difficult social circumstances
- Orthopaedic team consulted in perioperative clinic and discussed possibility of bilateral THR
- Surgeon decided not suitable for bilateral hip arthroplasty. Likely due to frailty.
- Discussion around optimal timing for the second joint replacement taking into VTE risk
- No evidence but consensus was sensible to leave 6 weeks between surgeries
- Update on case provided by procedural anaesthetist.
- Unable to attempt neuraxial block due to difficulty in positioning
- Significant post-operative delirium
- Would have likely been a poor candidate for bilateral joint replacements
- Predicted difficultly with rehab and post-operative mobilization due to severity of OA in other hip