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__For older people who fall and can't get up, odds are they've broken a hip.
__But with today's surgical materials and techniques, the odds also are they will soon be up and walking again.
__Generally, patients in otherwise good health who suffer a fall or have bone deterioration due to arthritis or other conditions are ideal for hip-replacement surgery. Such surgeries are performed most often on seniors.
__One such senior is Herb Persky of Cape Coral, who had both hips replaced about four years ago.
__"I had osteoarthritis, which causes a deterioration of the cartilage around the hip," the 79-year-old Persky said. "The pain was excruciating. I actually was a basket case for a while."
__His surgeries were done within a month of each other. He said he felt a lot of pain immediately after the surgery, then had to do physical therapy to rehabilitate himself and walk normally again. He started off on crutches and moved to a walker and then a cane. After about two months, he said he was walking on his own again.
__During his recovery, he needed help going to the bathroom and showering.
__"Now I feel pretty good about it. I walk two miles every morning and I feel great. I really enjoy life. I'm pushing 80 and feel like I'm 17. 1 would certainly recommend it."

Prime candidates
__Given the large numbers of seniors in Florida, Lee County orthopedic surgeon Abbott Kagan said surgeons in the state are often on the cutting edge when it comes to hip-replacement surgery.
__"We've been doing things down here for a long time that other areas of the country are just starting to do," Kagan said.
__Surgeons use a prosthesis that combines a cobalt, chrome or ceramic ball with a textured, rough stem made of titanium or cobalt chrome that a patient's bone will grow into.
__Bone growth usually begins within 10 days, and bone stability comes at about six to eight weeks. It may take as long as a year for full bone growth and stability, though.
__"But you don't have to rely on bone growth to be able to walk again," Kagan said. "Bone growth is necessary for long-term stability. Otherwise the implant will become loose."
__Kagan advises patients eat a healthy diet after the surgery to aid in healing, and to take a gram of calcium a day - something he thinks everyone should do. If you aren't getting that amount in your diet, he said, use supplements. Calcium prevents osteoporosis, a degenerative bone disease.

What's in a hip?
__A variety of materials have been used in hip-replacement surgeries, and Teflon was among the first. Other options were metal on plastic. But they would wear and could come loose, causing lesions in the bone.
__"The problem is the body is a very hostile place," Kagan said. So prosthetics have a hard time lasting inside the body.
Since Teflon, a variety of materials have been used:
__Titanium: Among the favored materials because of its durability and compatibility with the body.
__Ceramics: Research shows using a ceramic ball in a polyethylene socket means less wear and tear, but Kagan said such balls can break. If they do, "It can be very painful."
He doesn't like to use them.
__Metal on metal: Kagan said they show very little wear, but such hips have to be broken in "like you might break in an engine on a car. If you don't get a perfect match of the surfaces, you get very accelerated wear - and a release of metal particles. That can be dangerous, so it's still pretty investigational now. We're also looking at composites."
__Regardless of the materials, Kagan said there is no artificial hip that's going to last a lifetime. It's like buying a camcorder or a computer. When you need one, you buy the best one and hope it lasts. But there are no guaranties. __There's nothing better than what God gave us naturally."
Given that natural is best, some may wonder why hips can't be transplanted from donors - as organs can.
__"Technically, it's possible to do it," Kagan said, "but chances are it will fail, and we've got things that will work better than that."
__Among the problems: Finding hips that would match perfectly, preventing the body from rejecting the transplanted hip, and the difficulties with cartilage - which dies if it's frozen.

Risks involved
__As with any surgery, hip replacement poses risks.
__For starters, patients with heart problems are at high risk when it comes to surgery. Ditto for those who have had a stroke or who have some form of paralysis.
__Surgeons require such patients to see a specialist — such as a cardiologist for heart problems — to evaluate the risks of surgery. He said some patients want the surgery despite the risk.
__"They say 'life ain't worth living the way it is.' "
Kagan said surgeons generally will not work on Alzheimer's patients — they won't be able to follow the post-operative instructions.
__As with all surgeries, any time a surgeon cuts the skin, there's the risk of infection — which Kagan said could mean the loss of the hip prosthesis. That likely will result in one leg being shorter than the other.
__Surgeons use antibiotics to help prevent infection. But because such drugs have been over-prescribed in the past, Kagan said surgeons sometimes face resistant organisms. __And since the hip joint doesn't receive a lot of blood flow, sometimes antibiotics can't get to such organisms to fight off infection.
__Another risk stems from patients who overexert themselves too soon after surgery, sometimes causing the ball to come out of the socket — called a dislocation. It's extremely painful.

Story by Larry A. Strauss of the Fort Myers News-Press