“The greatest of all time”, is what they call him. His name is Edson Arantes do Nascimento, but most just call him Pelé. The Football Player of the Century according to FIFA has a new and popular documentary on Netflix. The way he once played soccer was referred to as “The Beautiful Game”, but now he is 82 years old and can be seen mostly sitting in a wheelchair on the sideline or barely ambulating with assistance.
Pelé has had problems with his mobility for many years. In 2012 he underwent hip replacement surgery in Sao Paolo, Brazil. Rehabilitation after his surgery did not go as planned. Ultimately, he traveled to New York City for a revision surgery in 2015. In addition to these issues, he has recently suffered from colon cancer, COVID, and a subsequent lung infection. Despite his recent maladies, his transcendent smile and personality cannot be deterred.
Debilitating hip arthritis can happen to anyone; even the greatest and most prolific soccer player of time. Fortunately for most, this is a manageable disease that is sometimes treated with hip replacement surgery [1]. Total hip replacement surgery has been referred to as “the operation of the century” in the general non-orthopedic literature because of its ability to reliably reduce pain and increase quality of life [2].
Complication rates of total hip surgery are rare as they are estimated to occur in less than 2% of cases [1]. The possibility of complications following surgery can be mitigated in a variety of ways. Some measures include antibiotics to prevent infection, anticoagulants to avoid blood clots, and newer implant designs and refined surgical techniques reduce prosthetic failure and dislocation risk [1]. However, for a small percentage of patients, complications can happen.
When issues arise with a total hip replacement, sometimes revision surgery is indicated. These complicated procedures are best left to the specialists with extra training dedicated to addressing these issues. These surgeons can be referred to as “adult reconstruction specialists” or “total joint surgeons”. With the increasing age of the US population and the use of modern surgical techniques and implants allowing younger patients to receive surgery, the rates of total hip surgery is expected to approximately double in the next 10 years [3,4]. As more total hip surgery is performed and in younger patients, revision hip surgery is also expected occur more frequently [3,4].
For Pelé, his declining mobility required hip replacement surgery and he subsequently needed revision surgery. In the hands of a specialist, it is possible for him to expect a good outcome. The majority of patients do well with just a single surgery, but it is important for any person undergoing revision hip surgery to see a specialist.
[1] American Academy of Orthopaedic Surgeons: Total Hip Replacementhttps://orthoinfo.aaos.org/en/treatment/total-hip-replacement/
Published June 2022 [2] Learmonth ID, Young C, Rorabeck C. The operation of the century: total hip replacement. Lancet. 2007 Oct 27;370(9597):1508-19. doi: 10.1016/S0140-6736(07)60457-7. PMID: 17964352. [3] Sloan M, Premkumar A, Sheth NP. Projected Volume of Primary Total Joint Arthroplasty in the U.S., 2014 to 2030. J Bone Joint Surg Am. 2018 Sep 5;100(17):1455-1460. doi: 10.2106/JBJS.17.01617. PMID: 30180053. [4] Maradit Kremers H, Larson DR, Crowson CS, Kremers WK, Washington RE, Steiner CA, Jiranek WA, Berry DJ. Prevalence of Total Hip and Knee Replacement in the United States. J Bone Joint Surg Am. 2015 Sep 2;97(17):1386-97. doi: 10.2106/JBJS.N.01141. PMID: 26333733; PMCID: PMC4551172.
By Chris Hoehmann, DO and Charles Ruotolo, MD
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