For nearly 30 years, Adam, an American patient, had lived with persistent hip pain.

What began as occasional discomfort while walking gradually progressed over the years. By the time his condition became severe, the damage to his hip joints had significantly affected his mobility and quality of life.

Eventually, his right leg became so painful that he could barely move it or stand.

His case ultimately led him to the Department of Joint Surgery at Southern Medical University Shenzhen Hospital, where doctors faced not only a severely damaged hip, but a complicated combination of medical conditions that made surgery considerably more challenging.

This article is independently summarized and adapted from a patient case published by Southern Medical University Shenzhen Hospital. China MedCare was not involved in the patient's diagnosis, treatment or care.

From Occasional Hip Pain to Losing the Ability to Walk

Adam first began experiencing hip discomfort approximately 30 years earlier.

Initially, the symptoms were manageable. The pain would improve with rest and pain medication, so he continued living with the condition.

Over time, however, the damage progressed.

According to the hospital's report, examinations eventually revealed extensive disease involving both hips, including:

• Bilateral femoral head necrosis

• Osteoarthritis of both hips

• Synovitis

• Subluxation of the right hip

• Collapse and deformity of the right femoral head

His condition deteriorated significantly during the six months before hospitalization.

Approximately one month before receiving treatment, Adam also suffered a fall and fractured three ribs.

Eventually, the hip pain became so severe that he could no longer walk and spent most of his time in bed.

After approximately three weeks of being largely bedridden, he also developed a pressure injury around the sacrococcygeal area.

At this point, the problem was no longer simply chronic hip pain.

His immobility was beginning to create additional health risks.

Hip Replacement Was Only Part of the Challenge

Hip replacement is a well-established orthopedic procedure.

But Adam was not a straightforward surgical candidate.

According to the hospital, his medical team identified numerous additional conditions and risk factors, including hypertension, bronchitis, hyperuricemia, gout, anemia, impaired liver function, low serum protein levels, lumbar degenerative disease, bilateral knee arthritis, urinary tract infection and other medical issues.

He had also recently sustained rib fractures.

Another significant consideration was his blood type:

A Rh-negative.

Rh-negative blood is relatively uncommon in China, potentially making blood management particularly important if significant bleeding were to occur during surgery.

The medical team therefore had to consider several questions before proceeding:

Could his cardiovascular and respiratory condition tolerate anesthesia?

How could surgical blood loss be minimized?

Could his infection risk be adequately controlled?

And how could prolonged immobility—and the complications associated with it—be avoided after surgery?

A Multidisciplinary Assessment Before Surgery

Rather than proceeding immediately with joint replacement, the orthopedic team initiated a multidisciplinary evaluation.

According to the hospital, specialists from several departments participated, including:

Joint Surgery, Anesthesiology, Respiratory and Critical Care Medicine, Laboratory Medicine, Gastroenterology, Nutrition and Nursing.

The objective was to improve Adam's overall condition sufficiently to make surgery safer.

His treatment before surgery included measures addressing infection, liver function, nutrition, pain management and electrolyte abnormalities.

Only after the team considered his condition sufficiently optimized did they proceed with surgery.

This aspect of the case is particularly important for patients with multiple chronic conditions.

For medically complex patients, the ability to perform the operation itself is only one part of the treatment process.

Preoperative assessment and management of the patient's overall health can be equally important.

Minimally Invasive Hip Replacement in Shenzhen

The joint surgery team developed an individualized minimally invasive hip replacement plan.

Because Adam's overall physical condition increased his surgical risk, the team sought to reduce unnecessary surgical trauma.

According to the hospital, particular attention was given to:

• Minimizing the incision

• Controlling blood loss

• Protecting surrounding soft tissue

• Accurate positioning of the prosthetic joint

The operation was successfully completed.

But another important part of Adam's treatment began immediately afterward:

rehabilitation.

Walking Again on the First Day After Surgery

The hospital used an Enhanced Recovery After Surgery (ERAS) approach to Adam's postoperative care.

This included individualized pain management, fluid management, infection control, nutritional support, nursing care and guided rehabilitation.

The goal was to help him regain mobility as soon as medically appropriate.

According to the hospital's report, on the first day after surgery, Adam was able to stand with the assistance of a walker and take several steps.

For a patient who had previously become largely bedridden because of severe hip pain, early mobilization represented an important milestone.

It also helped reduce some of the risks associated with prolonged immobility.

After decades of progressively worsening joint disease, Adam had begun walking again.

What International Patients Can Learn From This Case

Adam's experience highlights several considerations that may be relevant to international patients exploring orthopedic treatment in China.

1. Complex patients may require more than an orthopedic surgeon

Patients considering joint replacement may also have:

cardiovascular disease
respiratory disease
diabetes or metabolic conditions
anemia
previous injuries
infection risks
other chronic illnesses

For these patients, choosing a hospital with access to multidisciplinary care may be particularly important.

2. Ask about the entire recovery pathway

When comparing hospitals for hip replacement, patients often focus on the surgeon and the operation.

But it can also be useful to ask:

• How is pain managed after surgery?

• When does rehabilitation begin?

• How long is hospitalization expected?

• What mobility support is provided?

• What follow-up is required?

• When might the patient be medically fit to travel?

The surgery itself is only one stage of the treatment journey.

3. International patients should provide complete medical records

For patients with multiple medical conditions, previous medical information can be particularly important.

Before seeking an evaluation in China, patients may want to prepare:

• Recent X-rays, CT or MRI images

• Imaging reports

• Blood test results

• Current medications

• Previous surgical records

• Existing diagnoses

• Allergy information

• Blood type, if known

• Relevant specialist reports

The receiving medical team determines what additional examinations are required.

Hip Replacement in China for International Patients

Major tertiary hospitals in China perform large numbers of orthopedic procedures, including hip and knee replacement.

For international patients considering treatment, however, selecting a hospital should involve more than simply comparing hospital rankings.

Factors worth investigating include:

the experience of the joint replacement team, the patient's specific diagnosis, surgical approach, multidisciplinary support, rehabilitation services, international patient services and postoperative follow-up.

Patients with complex medical histories may also require evaluation by several specialties before surgery can be considered.

Important Medical Disclaimer

This article describes an individual patient case as reported by the treating hospital.

Individual outcomes vary. Hip replacement is a major surgical procedure and carries risks including infection, blood clots, bleeding, dislocation, nerve or blood vessel injury, implant complications and anesthesia-related complications.

Whether joint replacement is appropriate—and which surgical approach should be used—must be determined by qualified medical professionals after evaluating the individual patient.

Source: Patient case originally published by Southern Medical University Shenzhen Hospital. This article has been independently summarized and adapted for international readers.