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A 58-year-old male weighing 125 kg successfully underwent hip replacement surgery at a private hospital in Delhi after suffering from severe pain in his right hip for the last three years.
The pain was caused by Avascular Necrosis -- a rare and serious condition where bone tissue dies due to a lack of blood supply. The surgery, led by Dr Kaushal Kant Mishra, Director of Orthopaedics and Joint Replacement at Fortis Escorts Hospital, Okhla Road, New Delhi, lasted approximately 50 minutes. The patient was discharged in a stable condition just four days after the procedure. Such cases are rare due to clinical challenges involved in hip replacement procedures, particularly when performed on significantly overweight patients, which involve surgical complexities and post-operative success. The patient had been experiencing pain in his right hip since 2022. He was diagnosed with Avascular Necrosis at a city-based hospital in July 2022, where he underwent core decompression surgery. However, the relief was short-lived, as the patient continued to experience debilitating pain and difficulty walking. Despite multiple prior interventions, the patient remained in pain, highly dependent on pain medications, and unable to walk properly and walk with support. When he arrived at Fortis Escorts, his pain was so severe that it affected his mobility and quality of life. Diagnostic investigations, including X-rays and MRI, confirmed the advanced stage of Avascular Necrosis, and the team opted for a Total Hip Arthroplasty. Post-surgery, the patient began walking again, and within a short period, his weight began to decline, dropping from 125 kg to 123.3 kg at the first follow-up (one week after surgery) and further reduced to 119.2 kg after three weeks of surgery. Dr. Kaushal Kant Mishra said, "Overweight patients, especially those exceeding 100 kgs, are often hesitant to opt for joint replacement, and even surgeons approach such cases cautiously due to the complexities involved. The risk of infection, dislocation, and ultimately, patient satisfaction, is not good. Positioning the patient, approaching the joint, and intraoperative manipulation are far more difficult with patients of this weight category. But timely intervention was necessary to prevent lifelong disability. Often, when a patient stops walking due to pain, their weight increases, worsening the condition. Once they regain mobility, their weight naturally starts to reduce -- as we've already seen in this case. This case becomes significant, as it proves that even patients with higher body weights can undergo joint replacement safely, provided they are medically fit. The patient was allowed full weight-bearing on the day after the surgery. If left untreated, the patient would have continued to suffer from chronic pain, limping, and long-term osteoporosis, secondary spine degeneration." Dr Vikram Aggarwal, Facility Director at Fortis Escorts, said, "This was a challenging case considering the patient was highly overweight. However, due to the timely surgical intervention and comprehensive care by the team of doctors led by Dr Kaushal Kant Mishra at Fortis Escorts, he now has a renewed chance at a pain-free, active life. This successful outcome not only reinforces our position as a centre of excellence but also brings hope to patients across borders who are looking for advanced, life-saving medical solutions." (ANI)
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