✦ Joint Replacement for Trauma

Arthroplasty for Fractures

Q: Why is joint replacement sometimes better than fixing a fracture?

For specific fracture patterns — particularly displaced intracapsular hip fractures in elderly patients — the blood supply to the bone is disrupted and fixation carries a high failure rate. Replacement immediately eliminates that risk and provides a reliable, early-mobility solution.

Q: Which joints can be replaced following a fracture?

Hip replacement — hemiarthroplasty or total hip — is the most common post-fracture arthroplasty. Complex proximal humerus fractures are treated with shoulder replacement. Selected severely comminuted distal femur fractures adjacent to arthritic knees can also be treated with knee replacement.

Q: How quickly can a patient mobilise after arthroplasty for a fracture?

Weight-bearing typically starts within 24–48 hours in most cases. This early mobilisation is a primary advantage of choosing replacement over fixation — particularly important in elderly patients where prolonged bed rest carries substantial medical risks.

Q: What distinguishes hemiarthroplasty from total replacement following a fracture?

Hemiarthroplasty replaces only one articular surface — the femoral head in hip fractures. Total replacement resurfaces both sides. The choice depends on the condition of the opposite joint surface, patient functional demands, and their overall physiological reserve.

When a severe fracture has destroyed a joint surface beyond the reach of fixation, partial or total joint replacement is performed — restoring movement and independence more reliably than attempting complex internal repair.

60–120 min PROCEDURE

3–5 Days HOSPITAL STAY

>88% SUCCESS RATE

6–12 Weeks FULL RECOVERY

What is Arthroplasty for Fractures?

Arthroplasty for fractures replaces a joint — partially or totally — when the injury has produced irreparable damage that makes successful fracture fixation impractical or biologically unlikely. The most common application is hemiarthroplasty for displaced intracapsular femoral neck fractures in elderly patients, where disrupted blood supply makes avascular necrosis after fixation a significant risk. Shoulder hemiarthroplasty or reverse replacement is used for complex, irreducible proximal humerus fractures. Dr. Sai Kishan selects arthroplasty at Lux Hospitals when careful pre-operative assessment confirms it is the more dependable route to early mobility and reliable pain relief.

Indicated when a fracture involves the joint surface and reconstruction by fixation carries prohibitively high failure risk — particularly in elderly patients with poor bone quality, disrupted femoral head vascularity, severe articular comminution, or pre-existing arthritis that would render fracture fixation functionally inadequate.

How the Procedure Works

Fracture Assessment & Implant Planning

Fracture pattern, bone quality, joint surface damage, and patient functional expectations are assessed to select the optimal implant — hemiarthroplasty or total joint replacement.

Anaesthesia & Surgical Positioning

General or spinal anaesthesia; the patient is positioned appropriately for the joint requiring replacement.

Fracture Exposure & Fragment Management

The joint is exposed; irreparable fracture fragments are removed and the bone ends are prepared to receive the prosthetic components.

Trial Components & Sizing

Trial implants confirm appropriate sizing, joint stability, limb length, and range of motion before the definitive components are selected.

Definitive Implant Fixation & Closure

Final components are cemented or press-fit; soft tissue repair is performed; the wound is closed and early physiotherapy and mobilisation begin.

Outcomes

60–120 minDURATION

3–5 DaysHOSPITAL STAY

>88%SUCCESS RATE

6–12 WeeksFULL RECOVERY

Who Needs This Treatment?

→Immediate stability when fracture fixation biology or mechanics make it unlikely to succeed
→Weight-bearing and mobilisation begin within 24–48 hours — critical in elderly patients
→Eliminates the risk of avascular necrosis and non-union associated with femoral head fixation
→Avoids the morbidity of a failed fixation that later requires conversion to replacement
→More predictable recovery trajectory than complex internal fixation in appropriate cases
→Applicable to hip, shoulder, and knee fractures with specific patient and fracture criteria

Choosing replacement over fixation for certain fractures is not a concession — it is a clinical decision made in the patient's best interest. In the right circumstances, it is unequivocally the better operation.

— — Dr. Sai Kishan Sirasala, Knee and Hip Joint Replacement & Robotic Surgery

Common Questions

Frequently Asked

Why is joint replacement sometimes better than fixing a fracture?+

Which joints can be replaced following a fracture?+

How quickly can a patient mobilise after arthroplasty for a fracture?+

What distinguishes hemiarthroplasty from total replacement following a fracture?+

Not sure which treatment is right for you?

Book a consultation with Dr. Sai Kishan and get a personalised treatment plan.

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