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Total hip replacement (THR) at age 34 - help!

Posted , 7 users are following.

liamfahy7
liamfahy7

Hi,

After two failed hip arthroscopies (one involving microfracture), it's looking very likely that I'll need a total hip replacement - but having done some research I'm a little over whelmed by how many different types there are (cemented vs cementless, ceramic vs metal vs polyethylene, THR vs resurfacing). The main thing I can’t stop thinking about is that even if I get 25 years out of a new hip, I’ll still only be a very active 60 year old when it fails. So, I have a few questions for anyone who can help!...

1. How many revisions can I have? If only 2 or 3 then am I likely to be in a wheelchair by age 60-70?

2.  What type/material hip should I get? I know cementless has less statistics on longevity but does this give me the best chance of having a hip for a long time?

3. Is it easier to perform revision surgery on cemented or cementless?

At the moment I think a cementless ceramic on ceramic or ceramic on polyethylene might be my best options but I'm just not sure! It's such a minefield.

I have HEAPS of other questions but I don’t want to confuse this post by asking too many in one go!

Any advice and support is HUGELY appreciated,

Many thanks,

Liam

0 likes, 14 replies

14 Replies

  • Guest
    Guest liamfahy7

    Posted

    My consultant told me that they use cement hips only on people over 60 as there is less likelyhood of a reple=acemtn being needed. Under 60 they use cementless as the hip only last 15 to 20 years depending how active you are. They will replace 2 I believe but am not 100% on that and if thats the case. 34 +20=54 +20=74 not sure you another one done after that but then again medical science will have evolved before that time comes smile
    • liamfahy7
      liamfahy7 Guest

      Posted

      Thanks Gillcat- really appreciate the advice!
  • annedi
    annedi liamfahy7

    Posted

    I was more concerned about choosing the right surgeon. You should be able to find out who specialises in what and how many they do etc. Once I was happy with my choice I took the advice of the surgeon. First time 15 years ago i had metal with a plastic liner - it is still ok but there is some sign of wear on the liner. This time around for the other hip i was advised a ceramic on ceramic - as it was very hard wearing and would see me out (i'm now  62). I could have had the same as last time but took his advice.

    As for revision that would depend on what they had to do - I asked about my first one and if it were needed which it isn't yet they don't have to replace everything the stem and ball could remain in my case. I assume that different parts can fail.

    How long they last I would think would also depend on what you do when you have it- are you going to do a lot of sport for example and also what weight you are putting on it. I am very slight and have tried to be careful over the years since my first op. I have walked and do a lot of gardening but haven't done any impact sports.

    It is very difficult to advise when every one is different. I can only speak from my own experience.

    Good luck with your choice!

  • ian97093
    ian97093 liamfahy7

    Posted

    Hi Liam, thing is here you are asking yourself things that the surgeon will talk about, and will know about, it is better to get a good surgeon than a poor implant, just ask him how many he has done, get him talking and look him or her up on the internet, to see thier specialities, and second, I would say just calm down, and let the experts handle it.

    Kind regards Ian.

    • liamfahy7
      liamfahy7 ian97093

      Posted

      Thank you Ian. I'm hoping to see a lady named Sarah Muirhead who seems to be top of the game in the UK
    • sportsw4
      sportsw4 liamfahy7

      Posted

      Hey Liam. I also saw Sarah Muirhead - she's definitely one of the best known hip surgeons out there, but she does tend to want to whip you straight in to have the op. She really left me feeling there was no other option... but when I was forced to see a second specialist because my insurer wouldn't cover her costs, the guy I saw - who I liked a lot - was of a very different opinion. 5 years on and I still haven't had either hip done. I'm constantly questioning when IS the right time, as I know it'll have to come one day - but I do think she was too quick off the mark. However, if you're sure now's the time, there's no doubt she's a highly skilled surgeon... Good luck with it all, Mark
    • liamfahy7
      liamfahy7 sportsw4

      Posted

      Hi Mark - thanks so much for your reply. Can I ask who it was you ended up seeing? To be totally honest with you I'm very likely to need either THR or hip resurfacing as I'm two years down the line and have already had two failed arthroscopies. Also with Sarah Muirhead, did you get the impression she knew a lot about all the different materials and types of hip and wanted to make sure you got the right one? Or was it a case that she just wanted to use the same one she always uses? Really appreciate you help! Liam
  • christine2107
    christine2107 liamfahy7

    Posted

    Resurfacing is a good choice for men but done far less for women now due to poorer results. You get to keep bone for longer.

    Ceramic very strong but is catastrophic if it shatters - do you do activities likely to cause this to happen?  My consultant veered away from that as I am very active and he had just recently spent hours picking shattered ceramic out of a joint 

    There are lots of good consultants. There is also a cheeky piece of software / xray that you might ask for as it gives the surgeon the best ever information about how your hip and pelvis work and therefore the safe way to put in the cup - this is often a problem. Its by a company called Corin and is their Optimised Positioning system - worth everyone googling this one. I had it done and it turns out I have a huge pelvic tilt when I sit down - and my cup was placed safely. You can check surgeons performance out on the National Joint Register -see how many operations they do and mortality and other stats. Good luck - Chris

    • jennifer2000
      jennifer2000 christine2107

      Posted

      Hi Christine,

      Interesting perspective on ceramic, one I'd not thought of. What prosthesis did you end up going with?

      Jennifer, UK

    • liamfahy7
      liamfahy7 christine2107

      Posted

      Very interesting indeed! I had heard that ceramic was more prone to fracturing but not to shattering!

      I am 34 and would like to use my new hip to remain very active (cycling, swimming, lots of walking etc.) - so I imagine it's these kinds of activities that could shatter a ceramic hip right?

      It's a total contradiction really as the experts will say ceramic lasts longer so is best in younger and more active patients - but it's no use if it shatters!

      Thanks for your reply

  • dot60135
    dot60135 liamfahy7

    Posted

    Hi Liam, metal on metal is not often used now as they can need replaced earlier, although I was 61yrs old when I recently had mine, it was not due to arthritis but a serious accident. That morning I had been exercising a young, spirited horse and dismounted with a backwards sumersault!

    You have been given good advise, speak to your surgeon and by the way mine was cementless, told 20-25 yrs, total of 3 revisions possible so I could get into the history books ;-)

    Thake care, Dot

    • liamfahy7
      liamfahy7 dot60135

      Posted

      Thanks Dot! Good luck with it all and thanks for your reply!
  • christine69594
    christine69594 liamfahy7

    Posted

    Hi liamfahy

    My consultant said ceramic on ceramic is longest lasting so they tend to put those in younger people and cementless is easier to replace when it needs to be.

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