bilateral acetabular protrusio

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angie25

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Hi,

I have bilateral acetabular protrusio particularly effecting my left hip and has damaged a lot of the cartilage. I am 25 years old and this all started when I was 21 years old. I just had an arthroscope on my left hip last week. I am just concerned because it affects my flexibility badly... They say they won't do a hip replacement at my age because I am too young but I am just concerned that it will become stiffer. Why do they say that it is bad to have hip replacements at my age and also have many people had successful results in terms of flexibility?? Also, if anyone has this condition, could they please let me know of anything that may help.
Thanks so much,
Angela
 
The reason surgeons are reluctant to total hip replacements on people of your age is because we know for certain that they will need at least two if not three revisions in their life-time. Each revision becomes more difficult to do and more problematic for the patient so many surgeons will do almost anything they can do avoid it.

However, there is a possibility of hope for you but it rather depends upon the stage of your protrusio. If the acetabulum (socket) is normal or as near as, then you could be a prime candidate for resurfacing which is an alternative procedure devised specifically for the younger patient. It preserves the head of the femur and thus delays the inevitable revisions.

However, if there is a degree of damage to the floor of the acetabulum then it will not be appropriate and a total replacement will be your only choice. But still don't despair, I have seen dozens of young adults get THRs even as young as 19! And there are members on here who have had THRs at your age - search around the threads and find them.


Research ...
You should find a surgeon who specialises in hip resurfacing. They are few and far between as it is a technically demanding procedure and most hip surgeons prefer not to include them in their repertoire. Most resurfacing surgeons also do THRs ad also are specialists in dealing with the younger patients so find a good one and you will get the best of all options!

I did a search on resurfacing in Australia and came up with these

Sydney
broken link removed: https://www.hipresurfacingaustralia.com/hipresurfacing/

Canberra
https://www.canberrahipknee.com/resurfacing.html

Melbourne
broken link removed: https://www.melbourneorthopaedics.com.au/resurfacing.html

Brisbane
broken link removed: https://www.brisbaneorthopaedics.com.au/hips.html#hip_replacement

If you decide to investigate, I suggest you take along my questions from this post How to choose a surgeon and a prosthesis as they are still pertinent to choosing a resurfacing surgeon.

Keep us posted - let us know how you get on.


(Of course, inclusion of these sites does not in infer that BoneSmart promotes the centres or their standard of treatment. I just found them on a normal Google search.)
 
Thankyou so much Josephine for all your help and research! I really appreciate that! Unfortunately there is much damage to the acetabular wall and it is very thin on my left hand side. So it looks like THR is the only option for the left hand side if this arthroplasty has not helped.

On my right hip, the joint space is still well preserved.. However the surgeon says that i have also femoral acetabular impingement on the right side which he would like to perform another arthroplasty to remove that bone to prevent problems. Although, I would like to see about resurfacing for this right side if it starts to become a problem because at the moment it is not causing pain on the right hand side.

It is a relief to know that there are other people who are going through similar situations to be able to discuss with them how they feel about the whole process and discuss options.

Once again thanks so much,
Angela
 
Well, I hope all goes well for you. Keep us posted, eh?
 
Hi Angela,

Having a thinner wall on the acetabular side should not affect getting a resurface as opposed to a THR. On the acetabular side, they use the same type of cup. What matters is the condition your femoral head is in. There is a Dr. Shimmin in Australia that I have heard is really good. I know someone that went to him and had excellent results. His website is

https://www.andrewshimmin.com.au/

Only a very experienced hip resurfacing surgeon will be able to handle difficult cases which it sounds like your is. At your age, you should try to seek out a top surgeon for this. I also know of several patients that have had protrusio and had excellent results with hip resufacing. Dr. Koen De Smet in Belgium has done quite a few protrusio patients. Good luck.

Vicky
 
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