Question:The doctor says I'm too young (I'm 47) for a total hip replacement even though I have severe arthritis in one hip. What's the worst that could happen if I went ahead and had it done anyway?
Total hip replacement (THR) has always been reserved for older adults with pain and loss of function from arthritis. More and more young patients (less than 50 years old) are in need of help for severe arthritis.
Yet joint implants don't last a lifetime, so doctors want to wait as long as possible before replacing the joint. Studies show young, active patients have a high rate of revision surgeries after THR. Early loosening of the implant is common. Debris from the joint eats away at the bone causing this loosening.
A failed implant with revision surgery can leave the patient with one leg shorter than the other. Muscle weakness and scar tissue can also make daily activities difficult. Active adults find they can't engage in sports or recreational activities as they once did.
Doctors often suggest a hip osteotomy for the young patient with only one hip involved. This is a joint-saving operation that can buy the patient some extra time. It can reduce pain, increase motion, and improve function.Kenji Kawate, MD, et al. Twenty-five Years Followup of Patients Who Had Valgus Osteotomy for Arthritic Hips. In Clinical Orthopaedics and Related Research. September 2004. Vol. 426. Pp. 151-158.
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