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Knee & Hip Problems Message Board

Knee & Hip Problems Board Index


I am new to this site and I am very confused as to the best choice to make for a new hip. I am 31 yrs old. I was born with hip displasia, and had an osteotemy at 8mo. old. After I had my second little boy, who is now 4yrs. (1st was a crash C-sec) 2nd V-Bac; my hips started hurting more than the normal arthritis pain that I had experienced in the past. I had taught water aerobics and weight training before and during my pregnancy, so was in good shape for his birth, but my hips haven't felt the same since. Although, I wouldn't give up that natural birth for the rotated my hips into a new position. After 3 yrs of limping and pain, while finishing up at night school, I finally couldn't take it any more and went in for fluoroscopic injections (I will highly recommend them for pain), however, only the first one lasted longer than 8 mo. (which was well worth the pain relief) The next one wore off in about 3 mo.

I went in to an orthopedic specialist in Nov. I learned that I had a cyst on the head of the femur. All of the ligaments are torn up or gone. The bone is deterating fast, and he said that I needed a THR but was too young. He wanted to put in a metal on metal replacement, because I was so young and active, but scared because I am of child bearing age. Well, I have 2 boys 8 and 4 and explained that we are pretty much done. He still seemed unsure, and sent me to an osteotemy Dr.

The osteotomy Dr.said that he could help, and felt that my bone deterioration and arthritis wasn't to the point that the osteotomy wouldn't work. This was Nov. 26th. Sorry this is so long, I am very confused. I was scheduled for a GANZ osteotemy on Feb. 25th, 2008. Jan 29th, I came down with pneumonia and have been on antibiotics ever since. We had to reschedule the osteotomy for April 1st. Anyways, the pain in my hip has been so severe, worse everyday, it pops in and out while I am asleep, and the pain wakes me up and I have to pull it back into place, very painful. So I went in two days ago, to talk about possibly getting another shot to hold me over, and after he looked at the X-ray (he took that day) --all of a sudden he explained that I m pretty much out of luck now. My bone has deteriorated so much in the past 6 weeks since my last X-ray that he doesn't think that the osteotomy will give me complete pain relief. Well 80 to 90% for 2 yrs guaranteed 4 to 5 yrs max, and then I would prob. have to have the THR anyway. But, my hip is so screwed up due to the previous osteotomy, bursitus, etc., the surgery is difficult to begin with, let alone, I would probably have problems after the surgery due to all of the large scars from all of the other surgeries that I had as a child. OK, this Dr. said that I should get a ceramic on plastic hip replacement.

I'm not sure which one to get. I have been trying to find out which one is the best for my age, but it's really hard to choose. I am wondering if anyone has any suggestions about what materials are the best for 30 something, active people, who don't want to under go multiple revisions. The first hip guy said that if I start a THR now, I could end up in a wheel chair at an early age, and now due to the bone deterioration, I am being forced into it. We have already talked about hiip resurfacing, it will not help all of the various problems that I happen to have. My sockets are way to shallow and square. I have been told hat they would be very hard to operate on. Any suggestions about what type of hip replacement is the best?

I keep reading that the metal on metal gives a wider range of motion, but has the metal on draw back...any feedback on this? I have read that some people have had reactions to the ion debris left in their bodies, has anyone experienced this?

Then, I am concerned about the ceramic. I have read that they do not get good range of motion and can break easily. Does anyone have a ceramic on plastic that can give me feedback? Ceramic on ceramic? I have also been wondering about maybe metal on ceramic? Is that possible? Any other choices? Anyone have any ideas on what would last the longest with the best benefits all around? Any input would be greatly appreciated.

Thank you,
Hi Maggie,

No don't apologize, please feel free to share...that's what we are here for. I enjoy the conversation. We are all here to learn from each others experiences.

Have you looked into a possible PAO osteotomy to prolong the life of your hip? That was my only choice due to the bone deterioration. I had asked my Dr. about resurfacing as well, and it doesn't look like I am a candidate because of my bone loss. However, if you are....that would be my first choice, osteotomy second, then THR last.

I guess I'm at the last resort. Unfortunately, they have told me that mine will not be minimally invasive due to my previous osteotomies and I will take just a little longer to recover. The osteotomy/THR DR. said that it was going to be a difficult surgery, however, he felt confident that he could do the surgery.

I totally hear what you are saying about the night pain. I have learned to prop up my hip with a barricade on that side with pillows or blankets so that it doesn't turn out so far, and it hasn't popped out of place recently in my sleep. But it does throb, and every ,morning it is hard to get out of bed.

I felt the same way you did about prolonging the inevitable, I guess. Maybe I could just put it off another ten years of so. Unfortunately, I have been told that I will have to have it done anyway in a year and a half due to the bone loss. There is a small bone, the size of a dime holding the head of my femur in place, and if I loose this piece (due to deterioration) I could possibly miss my chance at having a replacement at all. Due to how shallow my socket is, they need that piece to make a deep enough space for the implant.

I'm thinking about going skiing in the next week or two, I have never been in my life, we live in WA, and I will probably never have a chance again. So, I thought I should do a couple of things that I may never have the chance to try. Hopefully I won't hurt myself too bad...hehe. I figured I'd stay on the bunny slopes with my 4 yr old. I'll have to talk my husband into letting me go.

I go in tomorrow to talk to the osteotomy/hip replacement guy. I have an appt with him to have it replaced April 1st. Now, I just have to figure out what type of implants I can talk him into using. I talked to the other DR. that likes to use metal on metal yesterday, and was told that he really didn't like to use ceramic due to their failures and clean ups after a break or fracture. I guess I'm stuck with metal on metal then? What else is there?

We'll see how it goes tomorrow. Have a good day!!

HI Mel52,
When you say they replaced the cup with titanium, and replaced the ball, did he keep the ceramic ball? I have been reading about this procedure lately, ceramic ball and metal lining. Is this a new procedure? I had asked the first DR's sec. about this (OK she is a secretary) but she had said that this guy (we can call him OS1) wanted to shy away from the ceramics due to the fractures and cracks. The OS that I am seeing today (OS2 - I am scheduled for a THR with OS2) likes to work with ceramics, however, he is the one who had suggested the poly lining, but everything I have been reading tells me that I will not be getting that one. I will ask him about the metal lining. He had told me that he didn't want to do the ceramic on ceramic due to the possibility of a squeaking hip. I have been contemplating this, and due to the fact that God might want to give me one more child in the future (plus we don't know the real long term effects) I am kind of shying away from the metal on metal (ions and all). It saddens me though, because I know that the metal on metal gives such a larger range of motion and a lower chance of dislocation.

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