For the Young at HipIf you are under 50 years of age with severe hip problems, you know that a total hip replacement often isn't possible. The reason for this is that joint replacements don't last forever. The average replacement is revised 15 to 20 years later. For a young person, this means an operation and new joint two or three times. There are too many risks with so many operations.
For teenagers or young adults with disease in one hip, there may be another choice. Hip fusion, called arthrodesis, saves the bone and gives pain relief for a long time. If the hip is fused in the right position, the other joints can be spared added stress. A good joint position also saves muscle bulk and strength.
Hip arthrodesis in the young patient has another advantage. It still allows the hip to be replaced with a new joint years later. This process is called conversion. The fusion is usually converted to a joint replacement when there is chronic back or knee pain.
There are other reasons to consider a conversion. Poor hip position from fusion may also result in loss of function. The patient has trouble getting shoes and socks on or using the toilet. Sexual activities may be difficult because of the loss of hip motion. If the leg is turned inward too much, the patient may actually trip over the turned-in foot.
Hip fusion is not the best way to treat severe hip problems in a young patient. However, it is an option that may buy some time while keeping the patient active and free from pain.
Paul E. BeaulÃ©, MD, FRCSC, et al. Hip Arthrodesis: Current Indications and Techniques. In Journal of the American Academy of Orthopaedic Surgeons. July/August 2002. Vol. 10. No. 4. Pp. 249-258.
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