34 yo old athlete recently diagnosed with Acascular necrosis of the femoral head

Hi...I'm new at this too..I'm gonna make my appointment in January or February..but believe me your at the right give it a few hours n people will help..good luck and I hope whatever outcome they are here with you ever step of the way.. Kathy

hi derrick, 

warm welcome to this hippies forum ...

I am not sure how to answer your question ... 2 Orthopedic surgeons advised hip replacement surgery ... if this is the right time or not, is up to you to decide ..

If you can live with it and perhaps can delay the surgery for a couple of months, go for it ...however, at the end it is not getting better and you will need THR ...

Do you know what caused this?  How old are you ? It sounds as if you are physically really fit and that will work to your advantage post-op ...

It reminds me of going to the dentist and tootch ache is gone ... doesn't mean that there isn't a problem ...

will they do bilateral surgery and use the anterior approach ?

Would you mid shring more about your self?

big warm hug

renee

 

Dear Derrick

you will hear many conflicting opinions regarding when is the right time.  

I have had both hips replaced, the first 15 months ago and the second 10 weeks ago.  I am 56 years of age and didn't have avascular necrosis but rather osteoarthritis but my advice would be to wait a while considering your relatively good state of health and degree of pain, which you state is rather minimal.  I guess the thing to remember is that prosthetic hips don't last forever and although much improved now and can last anything up to 20-25 years (I was advised), you are very much younger than the average patient and would almost certainly require a revision at some point.  Therefore, if you are able to manage your condition for a while, that is what I would do.  That said, there is a balance between all I've said and maintaining your athleticism which may be difficult with abnormal hip joints.  

Good luck.  

Joanne x 

Hi Derrick, difficult one. I agree with Joycy, you're so young, if you're not in lot of pain, then maybe wait a bit? That way you may only need one revision during your life. I was 57 when I had mine done in July. I had osteoarthritis, made worse by running. I waited about 5 years, until I was really limping, and feeling very uncomfortable at night. I'm not suggesting you wait that long though, because you also need to enjoy your life! If you're choosing when you have it done I would recommend Spring/summer, because then you can get out and about more easily afterwards.

Derrick

I agree with the others that if it isn't too painful it might be best to wait. But the other consideration is what sort of sport you will feel up to doing with a hip replacement. I've never felt happy running on mine and would feel even less happy playing volleyball because of the sudden movements. But I'm happy cycling, playing golf and walking. But then I had mine done when I was 60. I do remember reading about a judo champion who had a resurfacing done when quite young and carried on competing. So I suspect you have a difficult choice to make. Good luck.

Mike

Hi Derrick its a question only you can answer, but I agree at your age its a time scale thing, I'm not the best person to comment because I broke my hip/pelvis 6 months ago and chose to take the con route,I'm now going for MRI to see if like you its turned to avascular necrosis, I hope not as I'm just not keen on op, yours was probably brought on by the impact of sport, if I was you I would be inclined to discuss it in depth with your consultant and ask about you post op level of mobility, ie which high impact sport you will be able to do safely, once you know this you can make an informed decision, if your not going to be able to do all the things you love then you will know its not going to make a massive difference either way so could hold off how long do they say until femoral head collapses?

Hi Derrick, seems that most of my ideas are covered already here, but...

IMHO I would just say that it is a lot to go through, sounds like you will need both sides doing too, and that involves a lengthy recovery period, I was 9 weeks between operations at age 55,   and my Xray showed both sides to be like chewed up tennis balls inside,  wore myself out with so much excersise and weight training, but no self recriminations on all of that... we have Osteoarthritis, and have to deal with it, us Pirates On The Beach...

  I could choose which side to have done first, I should have had my left side done first,  but opted for the right to speed up recovery for driving and getting back to work,  in hind sight,  I should have had the left done first as that side is giving me problems now,

I get very sharp and painful shooting muscle pains down my left leg once I have rested, and have to sort of pull the leg round the pain,  by pushing my left heel into the floor, and twisting my muscles outwards, odd to put it like that but that is what I do.. and the pain goes away, no painkillers needed, and can carry on as normal,   as if I had no pain at all, ....but!!   then if I sit on a hard chair, WOW!! OMG!! Pain Again!!    Seems like 2hrs standing in one go is enough for me, and any more, sets it off again, I am off now for two days, and I stand a lot working in a Casino, so lets see, will post more on that after my second steroid injection, that is happening soon. ( Hope You like the Emocoms to brighten my post on such a serious condition)...

As folks have said, new Hips dont last forever... and you will have to have it all done again in your lifetime, as will I, but I would say, dont wait, allowing it to get worse, there is a whole world of much more debilitating pain on the horizon, and being a pavement shuffler, is not a nice condition to find yourself in. 

I was one...for five months, had to lift my leg off of the pavement into the car, and lucky for me I drive an automatic, as would not be able to have driven a manual safely, and at the end was almost in a wheelchair and could not really walk at all, but I am fine now......Hmmmmm.....Tear in my Eye  !! I know how you feel...

I am on the bright side now after 18 months, and it is a lot to go through, but well worth it, do not let your body waste away waiting too long, you loose your leg tone, and, get a weakened back, that all has to come back after the operations, just remember that will be two, too....

I hope you just get on with it as I did, and reclaim your life and change for the better, you cannot get better without it, but stay here with us on this site as we all know, and are a great comfort to each other in the intrim period.

Ian.

At age 68, was afflicted with this San thing. My femural heads collapsed. The pain was so debilitating. Had bi-lateral hip replacement on November 9th and am doing much better.

It is my understanding that the hips are only going to be good for around 20 to 25 years. At my age I didn't feel that would be a problem. I am now driving again but still have surgical pains et cetera.

You have to make this decision yourself. Best wishes to you whatever your decision.

I am 36 was a pro rugby player fought the pain for 4 years until it started to effect everyday life if you feel you dont need it dont have it your body will tell you. I had mine done 12 weeks ago im really impressed been backing spinning and circuit training since week 10 got my life back it all down to the individual as no two hip ops go the same way

Derrick as most have said you can only decide. I would ask the surgeons the question If I am doing ok at the moment and delay surgery, how much more damage am I doing to myself and will that affect the outcome when I have a THR.?This may make your decision easier. I had my THR done at 56, uncemented ceramic with titanium stem. Surgeon told me initially 20 years before implant would need replacing. Now he says it should last me a lifetime. Mine was due to osteoarthritis, too much sport when I was younger! Also think of the meds you are on and the implication they will ahve on your body in the long term. Good luck x

It sounds like your in pretty good shape at this time.The pain with hips can literally become crippling.I did Accupressure to improve circulation and Prolotherapy,which did not really help.According to the research I did things that would help for knee just don't work for hip.It seems with the hips being part of your core once they are shot they really do need to be replaced.Since they don't hurt badly now you have some time .4 months seems reasonable.If it works for you.Do your research,minimize progression of deterioration,get ready,go.I have 2 1/2 years of this progression.I just now had my last hip done.It has totally changed the quality of my life.I was so surprised as it went from barely bothering me to actually needing a walker to keep pressure off the hips.The Dr said the femur head was imploding upon itself. We have FMLA rules so between my bad knee and 2 bad hips it took me 18 months to get it done..Well good luck on your journey,sorry life is throwing you such a curve.

66 year old male, former Narine Corps Officer in good shape. I lived with worsening pain for 5 years. Took the pain meds and several steroid shots. Finally said it was time. Got the left hip totally replaced and pain free for a year now. If I was 34 I suppose I now would get it done because it does not get better, only worse. I just don't jump out of airplanes or run. Bike, hike, hunt etc. chances are you will need a replacement sometime in the future. Your 50's or 60's which then should last a lifetime. The more you pound on the new hip the quicker it will wear out. Best of luck

Hi derrick,

I was diagonsed with Avascular necrosis 2.5 yr ago, at the age of 28.

Originally my consultant said he wouldnt want to operate untill he really had to because of my age, and was even talking about 5 years time.

Within 6 months my condition had detoriated to such a degree where I couldnt work, was on crutches permantly and was struggling to sleep at nights.

My condition was caused by me breaking my hip 18months before being diagnosed 2 years before my THR , so your condition may not go down hill so quickly as mine, and having the THR was a huge relief and gave me a massive increase in quality of life 

In reply to your other post on the forum,

Recovery does depend on alot of things, as you mention. Also the stronger your leg muscles the quicker you should recover

what I would say is alot of people seem to be in a race to get back on their feet, I was the same. I think that is the wrong approach if it takes you 6 weeks to recover or 3 months in the scheme of things there isnt much differnce. The best process is too listen to your doctors and physio's instructions, do what they tell you efficiently, do as much as they tell you not more and not less. 

I also would'nt expect to be back playing any sports that involves contact or alot of running. You need to really look after your new hip as you want it to last as long as possible

hope that helps

take it steady

Elliot