My 15 year old having right hip done 7/12 with left set for 8/23

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tbatt9

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I've posted previously about our son Matthew and his bilateral hip problems. After much agonizing we've decided to proceed with hip replacements. His issues are different than what most experience in that his pain isn't the typical bone on bone arthritic pain but appears to be from deep bone pain due to necrotic bone inside his femoral heads and due to the abnormal anatomy which has both sockets flat and shallow. He's basically been having a slow motion collapse of his femoral heads due to the dead bone inside them. Instead of round balls his look more flat like mushrooms.

Lifestyle wise he has become increasingly sedentary over the last year since his diagnosis. Basically he can't stand for very long without needing to sit or lean on something. He can still do most things but it's harder and he pays the price later.

The hardest thing is to know if we are jumping the gun by electing to do this now on a kid so young. The surgeon basically says its up to us to decide if the pain is effecting him enough to merit it. But some days when he's just sitting around he has little to no pain. But then again that's the problem. A 15 year old shouldn't feel like he can't get off the couch without pain. But by going through this now his life is forever changed and he will wind up needing revisions in future as he wears these out. But his quality of life this year has really gone down hill and is unlikely to improve without this.

So that's his story. We are sick with worry about it but have decided at least for now to go through with it in couple days.

#teenagehipreplacement


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FWIW, I think you're doing the right thing. I think the decision has to be about quality of life now. He can't wait his whole life on the off chance that if he leaves it longer he'll never need a revision.

I'm sure everything will go well - try not to worry too much (easy to say, I know!)
 
Not an easy decision for an adult let alone for your child. But having experienced that bone on bone pain and a collapsed joint I can confirm you are doing the right thing. Sure, your son is young. But that's all the more reason. A 15 year old should be out and about having fun - not sitting around or limping everywhere.

You might want to check out a thread by @jasminesmom in the hip recovery area. Both of her children had THRs at around the same age as your son. They are both now reaping the benefits of life without pain.
 
His issues are different than what most experience in that his pain isn't the typical bone on bone arthritic pain but appears to be from deep bone pain due to necrotic bone inside his femoral heads and due to the abnormal anatomy which has both sockets flat and shallow.
In other words, he has dysplasic hips with AVN. We have had two other 15 year olds have hip replacements
teenager hip replacement after SUFE
Maya's recovery thread
But by going through this now his life is forever changed and he will wind up needing revisions in future as he wears these out.
Not necessarily so. Modern implants have extremely good longevity and even the earlier ones are proving to have a better survival rate than was ever expected! The is a very real possibility that your son would be in his 60s or even later before he has to face that. And the alternative is, as you know, he totally misses out on these formative and most exciting years of his life because of the mistaken belief that might have to have a revision in 40 or 60 years time!

You should read these
Hips that have lasted 32, 40, 41 and 45 years
67½ year old - the THRs, not the patient!
 
Thank you all for your replies. I keep struggling between fear and hope with this. Josephine, your comments are very reassuring and I thank you for them.

Also I am uncertain as to what type of short term and long term restrictions he will have. The surgeon will use a "minimally invasive" posterior approach and had said he should be up on his feet that same day and without a crutch or cane within 2-3 weeks. But what about the 90 degree rule? I have heard conflicting things about if it applies to this approach and if so for how long. Obviously we will follow whatever the instructions are but if anyone has had this approach I would love to hear about what to expect.


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@tbatt9 I feel for you what an incredibly difficult decision to make on behalf of your son. I tend to agree that it does in my humble opinion seem to me that you have made the right decision. I will pray for your son and family. Sending lots of positive vibes your way also.
 
But what about the 90 degree rule? I have heard conflicting things about if it applies to this approach and if so for how long. Obviously we will follow whatever the instructions are but if anyone has had this approach I would love to hear about what to expect.
I had mini-posterior for my LTHR. The restrictions are usually imposted for 6 weeks post op. I was very worried about the restrictions but they really were not difficult to follow. My new hip just did not want to move past the restrictions in those early days.
 
Thanks again for your replies, prayers, and kind words. As each day passes I find that I go thru stages where I am so scared for him that I'm certain that we should wait and cancel this until at least after his high school years are done.

But then I think about how he has already been affected by this and what the next couple of years may look like with him not wanting to participate in any social activities and just sitting around.

Now I'm getting very worried about the post op restrictions and how he will be able to adapt to them. Given those limitations he will have at least short term is that a reason to reconsider when looking at the fact that while his lifestyle clearly has been affected it hasn't reached the point of totally disabling him in that he can still function and get thru his day?

Another surgeon we saw tried to encourage him to just find a way to live with this as long as possible. He was an older doctor who didn't see many young patients and very rarely any kids. He made analogy that the surgery will not ever make you 100%. He said on a scale of 10 maybe it gets you to a 7-8, which if you are functioning at a 2 is an amazing improvement. But if you are at a 6 it's not likely worth it. The problem I have with that is it creates a situation where it seems that we are just waiting for him to slowly get worse and worse as his youth passes by with him sitting on the couch.

Sorry to go on at such length it's just that I'm so conflicted and scared that I'm making a huge mistake by having this done for him now.



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I had restrictions for five or six weeks with both THRs but it didn't really affect my ability to live life. As Jaycey said, in those early weeks I didn't really want to bend past 90 degrees anyway. I had a grabber and a long handled shoe horn and that meant I could do everything for myself if I needed to.

I think your surgeon who said surgery won't make you 100% was talking utter rubbish. I'm glad you found someone else. I'm still in recovery but I can feel things improving and I know it's just a matter of time and building up strength and stamina in my muscles. The actual joint feels normal already.
 
Now I'm getting very worried about the post op restrictions and how he will be able to adapt to them Sorry to go on at such length it's just that I'm so conflicted and scared that I'm making a huge mistake by having this done for him now.
Not all surgeons do that and he apparently didn't mention it in this
The surgeon will use a "minimally invasive" posterior approach and had said he should be up on his feet that same day and without a crutch or cane within 2-3 weeks.

Did you read the two threads I gave you links to? Both sets of parents were similarly conflicted, particularly Maya's Dad.

Ultimately you have to make the choice between giving them a good life NOW or letting him continue to live in pain and depression in these formative years. These problems will very likely give him an imprint of depression that will probably last for the rest of his life meaning he will always have a tendency to depression and anxiety. You can stop that happening now if you let him have his painful hip sorted our now.
 
Now I'm getting very worried about the post op restrictions and how he will be able to adapt to them.

I also had mini-posterior THR. My restrictions lasted four weeks and they really weren't a big deal. He is already restricting his motions and activity level to accommodate his pain. That pain is going to increase and cause him to adopt more and more restrictions. To me, it seems like a few weeks of minor restrictions are easier than the years of ever increasing pain and disability that are in front of him with his natural hips.

He was an older doctor who didn't see many young patients and very rarely any kids. He made analogy that the surgery will not ever make you 100%. He said on a scale of 10 maybe it gets you to a 7-8.

Clearly, he doesn't treat many younger or more active patients. If that's the kind of result that his patients typically have, I would stay very far away from this surgeon. I know dozens of people, both online and in real life, who have returned to very high activity levels post-THR. I have a friend with a 15-year-old THR, who is on a 100-mile bike ride through the mountains today. I have an online acquaintance who climbed Mount Everest after his THR. I compete in trail runs and Olympic distance triathlon and am competitive in my age group. None of us are operating at only a level of 7 out 10.
 
So we are checked in to the hotel attached to the hospital and Matthew is showering with the special soap. 7am he goes in for the right hip. No turning back now. I guess tomorrow as I sit and worry I'll start a new post on the recovery side.

Thanks to all for your supportive comments. I don't think I could get thru this without this outlet and resource.


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@tbatt9 i also believe you and he are making the right choice. He'll adapt to those temporary precautions with the élan of the very young.
I have a friend whose younger son has a horrible bone disease which has required 1-2 major surgeries per year most of his life (he's now maybe 18) to remove bone overgrowths all over his body. He has worn elbow crutches, a motorized scooter (he and his older brother did hot rod racing with that one) and bandages and pain all his little life-- and he always adapts, each time.
He will be 100%, and on a varsity sport team, you wait and see. His current pain and disability would ONLY get worse with time. This way, he'll be ready for his learner's permit pretty much on time-- imagine him like some of us-- I, for example, have stopped driving our standard shift car because working the clutch is so painful.
He'll be up and walking as soon as his vitals are good enough! I, at 61 for first hip, was up walking about five hours after I got back to the room, and remember taking myself to the bathroom in the muddle of that first night. Passed walk-about and stairs tests about 2:00 next afternoon, and was already finished with discharge paperwork before that.
If he's your oldest? Believe me, it will be much easier on both of you than if you waited a year or so longer-- I cannot imagine nursing a 17 yr old boy, large, surly, angry, rebellious, through recovery!!!
Ice, ice, ice, elevate, pain meds by the clock, the Roku remote in one hand and the phone in the other-- you have it covered!! :) chris


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Good luck for your son today. I think you have made the right decision and I'm sure he'll be so grateful that you have supported him to have this surgery. Do keep us posted on his recovery.

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I wanted to say I am thinking about you and your son as well. I cant even imagine as a mom having to make this decision. Stay strong and please update us. Im sure he will fly through all of it with flying colors. :)
 
So we are checked in to the hotel attached to the hospital and Matthew is showering with the special soap. 7am he goes in for the right hip.
That is fantastic! We're all routing for you both!
 
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