Hip replacement under 30
Discussion
Apologies up front but I'm an existing member posting under a new account as this is related to someone close to me who I do not want to identify.
Following three operations for Developmental Dysplasia of the Hip before the age of three a young person I know who is in some pain has been offered a Total Hip Replacement privately whilst still under 30. They understand that in all likelihood they will need it at some point soon and therefore almost certainly need another one later but I'm trying to help them understand if there are options at this point even to push the first one out by a few years. Ideally I'd love to connect with someone who has a similar experience or some expert knowledge. They could go to the NHS for a second opinion but I think it would probably take longer than there is before the private operation would be done.
Following three operations for Developmental Dysplasia of the Hip before the age of three a young person I know who is in some pain has been offered a Total Hip Replacement privately whilst still under 30. They understand that in all likelihood they will need it at some point soon and therefore almost certainly need another one later but I'm trying to help them understand if there are options at this point even to push the first one out by a few years. Ideally I'd love to connect with someone who has a similar experience or some expert knowledge. They could go to the NHS for a second opinion but I think it would probably take longer than there is before the private operation would be done.
Hi. The options really depend on the degree of degeneration that has occurred and the amount of pain they are in and its impact on their life. In terms of options there are conservative measures such as weight loss, cushioned shoes, walking aides such as walking poles or sticks and analgesia. Low impact (open chain) exercises such as cycling or swimming may help some people who can manage to do them. The next level can be injections with steroids and or local anaesthetics but this is not curative. Hip replacements are very good for pain relief but do have a finite lifespan and have risks such as dislocation. Hip resurfacing maybe beneficial in active younger males but can depend on the size and shape of the hip which may be a problem in dysplasia.
speedster986 said:
Hi. The options really depend on the degree of degeneration that has occurred and the amount of pain they are in and its impact on their life. In terms of options there are conservative measures such as weight loss, cushioned shoes, walking aides such as walking poles or sticks and analgesia. Low impact (open chain) exercises such as cycling or swimming may help some people who can manage to do them. The next level can be injections with steroids and or local anaesthetics but this is not curative. Hip replacements are very good for pain relief but do have a finite lifespan and have risks such as dislocation. Hip resurfacing maybe beneficial in active younger males but can depend on the size and shape of the hip which may be a problem in dysplasia.
Thanks for the quick answer. It's a woman so I presume resurfacing is out. I think most of the other options you mentioned have been considered already and are either already being done or dismissed for a specific reason so it seems like she's getting good advice.I’m 43 and had a THR in May last year, in 2015 I broke my neck of femur and whilst that was fixed with cannulated screws what happens is that the blood supply to the femoral head eventually dies off and you end up with avascular necrosis.
I started suffering with horrendous pain early in 2024, went from cycling 100+ miles a week at a good level to being barely able to walk in the months before my operations.
I say operations because I first had to have the cannulated screws removed, let that heal and then 3-months later have the THR.
Both operations were undertaken at Nuffield Clifton but a great surgeon. I am still recovering tbh, the back to back operations really took a toll on my leg muscles but the hip pain has totally gone.
I too will need another THR in time but it had to be done as I was in so much pain and losing mobility.
I started suffering with horrendous pain early in 2024, went from cycling 100+ miles a week at a good level to being barely able to walk in the months before my operations.
I say operations because I first had to have the cannulated screws removed, let that heal and then 3-months later have the THR.
Both operations were undertaken at Nuffield Clifton but a great surgeon. I am still recovering tbh, the back to back operations really took a toll on my leg muscles but the hip pain has totally gone.
I too will need another THR in time but it had to be done as I was in so much pain and losing mobility.
Lots of very good stuff above, accurate and useful.
I don't do primary hips I do knees, but I am a high volume surgeon
https://boneandjoint.org.uk/Article/10.1302/1358-9...
-is a seminal paper and basically says that a well performed Cemented Exeter total hip could be the last operation you ever have. The paper was written by the Exeter gang though.
A ceramic ball on a polyethylene cup, can be a perfect bearing surface, even if the cup wears out at 30yrs, you can redo the cup only.
Its a very technical discussion, so just find a surgeon who does lots of hips a year.
I don't do primary hips I do knees, but I am a high volume surgeon
https://boneandjoint.org.uk/Article/10.1302/1358-9...
-is a seminal paper and basically says that a well performed Cemented Exeter total hip could be the last operation you ever have. The paper was written by the Exeter gang though.
A ceramic ball on a polyethylene cup, can be a perfect bearing surface, even if the cup wears out at 30yrs, you can redo the cup only.
Its a very technical discussion, so just find a surgeon who does lots of hips a year.
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