BEST-RATED NYC ORTHOPEDIC HIP SURGEONS

Hips, especially for elderly patients, are a vital area when injured. Hip injuries affect everyday life and are debilitating. Fortunately, NY Bone and Joint Specialists’ best-rated NYC hip surgeon, Rupesh Tarwala, MD, is one of the most skilled and highly regarded hip surgeons, not only in the New York area, but throughout multiple countries. Rupesh Tarwala, MD has received the most advanced training available and is the leading expert in surgical repair of hip fractures and hip joint replacements. Athletes and non-athletes alike from around the world seek Rupesh Tarwala, MD specifically for his top hip surgeon reputation.

At NY Bone and Joint Specialists, we take hip injuries very seriously. Our top-rated orthopedic surgeons are available for urgent cases and same day appointments. Our staff is dedicated to handling all insurances processes so you can receive the top rated orthopedic care in New York City without the cost. Our hip fracture patients can expect a friendly and helpful atmosphere at our Upper East Side, Midtown Manhattan,Englewood,NJ and Hoboken, NJ locations when coming for follow up visits, physical therapy, or other routine therapies. Our mission is to always provide you with the highest quality care possible by the best doctors and staff in New York.

DESCRIPTION

Hips have a stable ball and socket joint that supports our entire upper body and allows us to walk and move properly. The ball end of the femur, or thigh bone, connects to the socket of the pelvis to form the hip. Hip fractures, however, are not injuries to this joint but actually damage to the upper portion of the femur bone close to the hip. A fracture in this area will cause hip pain and issues using your hip even though the fracture is in upper part of your thigh bone. The bone can fracture in a few different ways and areas of the bone.

Intracapsular Fracture – This fracture affects the part of the neck of the femur that is inside the joint capsule, covered by the cartilage and fluid that holds the hip joint in place.

Intertrochanteric Fracture – This fracture occurs at or below the neck of the femur where it extends from greater trochanter to lesser trochanter. The greater trochanter lies at the upper and outer part of thigh bone and can be felt as a prominent bone near the side pocket area of your pants. The lesser trochanter is a small protrusion on the inner side of thigh bone. Both the greater and lesser trochanter connects many of the important muscles in the pelvis and thigh area.

Subchanteric Fracture – This fracture happens just below the lesser trochanter, at the top of the femur bone.

CAUSES

A severe impact is needed to damage your femur, so it is often the result of a sudden sport or motor vehicle accident. Elderly patients, or patients with medical conditions that make bones more brittle, are more susceptible to fractures and breaks. Osteoporosis, osteogenesis imperfect, or even cancer deposits (metastasis) are a few conditions that can cause bone weakness. When bones are weak, small stress fractures can form even from slight impact.

SYMPTOMS

Hip fractures will cause pain in your groin area. Your pain will increase as you bend and rotate at the hip. Pain can vary in severity, but it will probably keep you from bearing any weight on your affected leg or walking. If the femur has completely broken, your leg will appear shorter and pointing outward.

DIAGNOSIS

Rupesh Tarwala, MD, a best-rated NYC hip surgeon, will be able to easily diagnose a hip fracture after inquiring about your pain, your medical history, and physically examining your hip. An x-ray will capture a clear image of a hip fracture. With an X ray image, your Rupesh Tarwala, MD, will see what type of fracture you have and how severe the breakage is.

TREATMENT

Hip fractures are rarely treated with solely conservative methods. A hip fracture, even if it seems to be in proper position to heal, can easily become displaced. To prevent displacement, Rupesh Tarwala, MD, will take frequent follow up x-rays and suggest you stay on bed rest. Staying immobile for this long can cause other health complications. For this reason, conservative treatment is usually only considered for those not healthy enough to undergo surgery. Rupesh Tarwala, MD will be sure to explain your condition thoroughly and prepare you for your surgery so you feel comfortable with your treatment. You can be sure that you are in the best hands with our top orthopedic surgeon, as Rupesh Tarwala, MD received extensive training in orthopedic hip surgery in multiple countries under the guidance of top leaders in the orthopedic field.

SURGICAL

BEFORE SURGERY

In almost every case, general anesthesia or spinal anesthesia will be used during a hip surgery. Rupesh Tarwala will prescribe you antibiotics pre-operatively and for 24 hours after surgery to avoid infections or complications. Rupesh Tarwala, MD, will also give you specific instructions, such as not to eat or drink twelve hours prior to surgery. Wear comfortable clothes to your hospital visit and arrive two hours prior to your scheduled surgery time to fill out paperwork and receive instructions. Prepare to stay in the hospital overnight and arrange for a ride home when necessary, since anesthesia effects patients differently and sitting will cause you considerable discomfort after surgery.

SURGERY

The type of surgery Rupesh Tarwala, MD, will perform depends on the type of fracture and its severity. The goal of all surgeries to correct hip fractures is to hold the femur bone securely in place to allow the bone to heal back together in a proper position. In severe cases of hip fracture, Rupesh Tarwala, MD, may suggest that a partial or total joint replacement would work best in returning your mobility.

Intracapsular Fractures – For fractures that occur in the femoral neck, a single screw, two screws, or single screw and compression plate will be sufficient to keep the bone in place as it heals. Rupesh Tarwala, MD, may enter the front and/or back of your hip in order to visualize the joint. Dr. Tarwala will then be able to remove damaged tissue and reconstruct damaged acetabulum.

Hip Joint Replacement – It is possible in both elderly and younger patients that complications can cause long term issues after surgery. If the head of the femur is damaged, it may prevent an adequate amount of blood from reaching the underlying bone and supportive cartilage, despite its being screwed into place. If this happens, the cartilage will gradually deteriorate, followed by the bone underneath, causing the joint to destabilize and arthritis to form. If Rupesh Tarwala, MD, believes that the femoral head has undergone enough damage that this situation is possible, he will probably suggest a partial or total joint replacement. In a partial hip joint replacement, only the ball on the femoral head is replaced with a plastic prosthesis that is cemented into place. The need for a joint replacement is higher in elderly patients since older bones are weaker and cartilage is less able to maintain itself. A total hip joint replacement will replace both the ball and the socket of the hip bone with plastic and metal prostheses.

Intertrochanteric Fractures – These types of fractures are usually simple to manage. Your orthopedic hip surgeon, Rupesh Tarwala, MD, will make an incision at the side of your hip. A screw inserted into the femur neck will cross the fracture and be stabilized by a metal plate held alongside the femur bone or nail inside the bone. With steady physical therapy and regular follow ups with Rupesh Tarwala, MD, this type of fracture should heal in 3-6 months.

Subtrochanteric Fractures – These fractures are typically easier to manage surgically. Rupesh Tarwala, MD, will use imaging to determine if screws or plates and nails are best to hold the bone in place during healing.

POST-OPERATIVE CARE

Some hip reparation surgeries are simple enough that you will be able to return home that night. Other open surgeries, namely joint replacements, will require a 1-3 days stay in the hospital. Following the surgery, physical therapy is crucial to regain your ability to walk properly and to help the bones in your hip heal properly. Your physical therapy regimens will begin with small movements, probably for the first three months. When your hip is stable enough, stretching and strengthening will help you regain normal mobility. Following our physical therapy program regularly is the most effective way to make sure you regain your range of motion, you maintain a proper gait, and your tissues heal without stiffness and scarring. Your top rated NY Bone and Joint hip surgeon Rupesh Tarwala, MD, will follow up with you often, taking X rays, to determine how well your hip fracture is healing. Your physical therapist will also track your progress and make changes to your routine based on your comfort levels. Most, if not all patients, regain their independence and mobility after undergoing a hip fracture correctional surgery.

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