My grandfather had a hip replacement for severe hip arthritis when he was 55. It's lasted him a good 25 years now. I have the same problem but my pleas for a hip replacement seem to fall on deaf ears. No one wants to touch me. Can you explain this to me?
Total hip replacements are well designed but still only last 10 to 15 years for the average patient. Younger, more active patients put more stress on the implants than older, sedentary adults. So if the implant only lasts a decade or so, another surgery is going to be needed. With each operation, there is a small amount of bone loss and the potential for problems. Studies have shown surgeons the need to evaluate each patient carefully and avoid surgery too early in the disease process.
Fortunately, a new way of treating disabling hip arthritis in younger (less than 65 years of age) patients is now available. This procedure is called a surface replacement arthroplasty (SRA). SRA is a type of hip replacement that replaces the arthritic surface of the joint. But it removes far less bone than the traditional total hip replacement.
The surgeon shapes the bone of the femoral head and then fits a metal cap snugly on top of the bone like a tooth capped by the dentist. The cap is held in place with a small peg that fits down into the bone. The patient must have enough healthy bone to support the cap. The hip socket may remain unchanged but is usually replaced with a thin metal cup.
No one is sure yet how long the SRA will last. Studies so far report excellent results in the first five years. That buys the patient some time before converting to a total hip replacement. It's a nice stopgap measure for patients like you who are too young for a total hip replacement but too disabled to wait years and years for the help they need now.
Aaron K. Schachter, MD, and Justin G. Lamont, MD. Surface Replacement Arthroplasty of the Hip. In Bulletin of the NYU Hospital for Joint Diseases. March 2009. Vol. 67. No. 1. Pp. 75-82
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