Well, I hate to admit it, but Mother is a bit of a drinker. We didn’t tell the doctor, and now she has fallen and dislocated her new hip replacement. Should we say something? Or is it already too late?

Most surgeons perform a screening exam to look for high-risk patients. Patients who are considered high-risk don’t just have problems with alcohol use and abuse. They may have other significant health problems. Dementia, Alzheimer’s, diabetes, and heart disease are common in older adults who need a hip replacement.

The presence of a drinking problem doesn’t mean the patient can’t be treated. First of all, even older adults can get help for an addiction problem with alcohol or other drugs. A psychologist or social worker in the community who specializes in this type of problem can be very helpful.

Second, precautions can be taken to prevent falls and hip trauma. A physical therapist is the best one to assess both the patient and his or her home for ways to reduce the risk of falls and fractures or dislocations.

Third, if revision surgery is needed, the surgeon may want to put the patient in a brace or cast to slow him or her down and give the soft tissues a chance to heal. Sometimes, for the older adult (and especially someone with weak muscles or lax (loose) soft tissues), a specific type of implant is used that is less likely to dislocate. The surgeon may choose an implant with a larger femoral head and then cement the socket portion in place. Both of these steps help stabilize the joint.

So, it’s never too late to offer information that can help direct and guide treatment as well as prevent further complications. It may be best if the patient (in this case, your mother) disclose this type of information to the physician. Encourage your mother to confide in her surgeon. Having them work together to solve the problem is usually more helpful than family members stepping in without the patient’s permission.