Hi all, does anyone know of someone with a spinal cord injury being given a hip replacement or some form of surgery for a broken hip.
I have a four month old ' sub capital fracture' and it was only discovered two weeks ago due to nobody being prepared to listen to my requests for help.

I knew i had a serious problem, somewhere in my pelvic area, as after having an operation in December 08 for a bladder problem and being discharged my balance, seating, posture, leg length, etc were all completely different and i was physically very unwell! My leg was swollen like a balloon and spasming like crazy. Finally i was xrayed after begging umpteen dr's for three months and now they are telling me i cannot have it operated on as i do not have enough muscle mass in my hip area. I am not too happy at this as i am now going around with a fractured hip and terrified of what this means in the future. Any advice will be appreciated... thanks..

Hi - this reply is so late, given that you probably have already seen a million doctors by now, but I thought I'd pipe in here.

I have a chronic hip problem - I have a pediatric SCI, which causes muscle imbalances while you are growing, leading to things like hip dysplasia and dislocation. I had my right hip "relocated" using surgery when I was 9, and now 20 years later, have intense, constant pain from that hip. X-rays show that my femoral epiphysis (the round ball-part of the femur where it contacts the pelvis) has completely collapsed due to osteopenia and improper bone modeling.

I saw an adult complex-joint Orthopedic surgeon who said he wouldnt' touch my case with a 10-foot-pole. No offense to me, but apparently hips in SCI population are very complex and not something to be treated by someone inexperienced. I was referred back to the orthopedic surgeon who did my original surgery when I was 9, who was able to help, but my one option is a Girdlestone Arthroplasty, wherein the capital femoral epiphysis (the ball part again) is removed (resected) completely and wrapped in muscle and fascia, then fixed into the acetabulum (the socket part of the hip joint, part of the pelvis) with hardware.

You lose up to 2" of your leg length this way, not to mention it sounds gruesome. I was told by everybody - I mean everybody! - that hip replacement was simply not an option because paraplegics don't have enough muscle tone or fascia to keep the hip replacement in the socket. The danger of dislocation and breakage of the bone at the point where the implant meets the femur (thigh bone) is so high, and the risk of infection extreme that no orthopedic surgeon worht his salt would ever attempt it. I was disappointed because it seems like nobody really cared about finding me a solution that fit my activity level. A girdlestone procedure is disfiguring and permanent, and requires you to be constantly in a sitting position on that side, which I know already my trunk and hip muscles will punish me for. My own pediatric ortho surgeon mused about creating a metal connector that could replace the epiphysis enabling me to sit or lie down but would anchor my hip to the pelvic bone through the acetabulum, eliminating the need for the Girdlestone or the hip replacement.

Sounds gruesome too, but was a better middle ground for me. I elected to control pain with meds for now until I had no other options, and asked the ortho to put some thought to his new idea. The worst case scenario for it is - you guessed it - it doesn't work out and I get a girdlestone procedure done anyway. so there's not much to loose.

Best of luck with everything - I stumbled across this post because I started having MUCH more trouble with my hip this week, to the point that I can't sit on the toilet or on my Ride cushion without extreme pain - which makes me think I may have finally fractured the hip at last. So... now I'm in the same boat, I hope that there are more options out there for me. Here's some of the research I did on it, for those who are interested:

(not para/quad specific)
Total hip: alternative operations : http://www.totaljoints.info/TH_alternative_operations.htm

Research article: Total Hip Arthroplasty (hip replacement) of the paralytic hip. Wicart et al. http://www.ncbi.nlm.nih.gov/pubmed/1057572...mp;ordinalpos=4
There's not a whole lot out there, but this was one of the best.

Here's one that might be interesting: Weber, M., and Cabanela, M. E.: Total hip arthroplasty in patients with low-lumbar-level myelomeningocele. Orthopedics, 21: 709-713, 1998.[Medline]
not the same thing, but effectively a congenital SCI.