THR Too young for a hip replacement at 24?

[KKJ18]

Hi there! I came across this forum while doing research on a THR, and it looks like others have been given great support/advice… I understand no one but my doctor can actually give medical advice but I’ve been presented with multiple options by my surgeon and I’m not sure which route to go. I am also seeking another opinion but for now I’ll just explain what I have been told so far.

My hip pain started when I was 16, primarily while horseback riding. X-rays didn’t show much so we decided to proceed with PT and I experienced slight improvement but not much. By 19 I made the decision to stop horse back riding competitively, and other hip aggravators focus on my career (airline pilot) which requires me to remain in good health. At 22 the pain started impairing day to day life and I returned to a different doctor, where I was formally diagnosed with FAI in both hips. Both hips have labrum tears and degeneration. The right was more symptomatic so I went ahead with an arthroscopic surgery to repair the tears and correct the cam/pincher deformity. The surgery failed and 2 years later, my right hip is even worse than before and now I am being presented two options by another surgeon.

A THR or a reconstructive surgery to replace my labrum, and correct even more overhang on my hip. I have been told the reconstructive surgery will not provide 100% relief and is more to buy myself more years before the THR. In his opinion, if I was older he would elect for the THR but as I am only 24, I am definitely looking at a revision, possibly multiple over my life time.

I feel like so much of my life has been restricted due to this problem. I can’t ride my horse anymore with out constant pain, I can’t dance or hike like I want to without pain.. But I am still active, I can climb stairs and bend without much pain… I don’t feel like I live the lifestyle one would think of for a THR. I don’t know of anyone in my life that has had a joint replacement this young and I’m not sure if I should prioritize the years immediately in front of me, or the future 50 year old me that will need a revision. I fear the reconstruction will be another failure, and the money and time lost with be for nothing… yet a THR at 24 is terrifying.

Any advice is appreciated even if it’s just words of encouragement.

 

[Caison113]

First of all my sympathies. This is definitely hard to consider at your age and it sucks that there aren’t better options. I would thoroughly research the success rate of the labrum reconstruction. I know you said it wouldn’t be 100% and it would just buy time but I’d try to get very specific on what that means. Buy you 5 years or 15?

The replacement will definitely fix the problem but of course you will be facing a revision in 15-25 years as you mentioned. That said things can really change in that time and the next one could be even better. Have you looked into the resurfacing option? That might be a good middle ground.

 

[KKJ18]

He seemed unsure of the amount of time the reconstruction would provide. Hopefully 5 to 10 years is what I believe he responded with.

I have lightly looked into resurfacing but generally most information discourages the procedure in women. Is this dated information? And should I find a hip resurfacing surgeon for that second opinion then?

 

[djklaugh]

@KKJ18 Welcome to BoneSmart! We have seen many folks here your age and younger getting hip replacements .... and those folks returning to active life styles and even physically rigorous jobs. We've even seen teenagers getting new hips. The implants of today are expected to last 30+ years. And alas the experience we've seen here with folks getting any kind of reconstructive surgery has been less good than the hip replacement results.

Hip: pre-surgery considerations

If you are at the stage where you have joint pain but don't know for sure if you are ready to have surgery, these links may help:


Score Chart: How bad is my arthritic hip?
Choosing a surgeon and a prosthesis
BMI Calculator - What to do if your surgeon says you're too heavy for joint replacement surgery
Longevity of implants and revisions: How long will my new joint last?

If you are at the stage where you are planning to have surgery but are looking for information so you can be better prepared for what is to come, take a look at these links:


Recovery Aids: A comprehensive list for hospital and home
Recliner Chairs: Things you need to know if buying one for your recovery
Pre-Op Interviews: What's involved?

And if you want to picture what your life might be like with a replaced hip, take a look at the posts and threads in stories of amazing hip recoveries

 

[JusticeRider]

Hi KKJ18, welcome to BoneSmart! I am usually on the knee side of things here, recovering from a partial knee replacement. I have also had two surgeries on my hip to address cam and pincer impingement and a torn labrum. I had my first FAI surgery when I was 37. I too ride horses, as well as hike, trail run, and snowshoe. So I understand wanting to get back to an active lifestyle. Recovery from the first surgery was difficult, but I was able to fully return to my previously active life. About 6 years later, the same symptoms as before returned. It turns out there was still some impingement left that was missed in the first surgery, and I had re-torn my labrum. The second surgery (different surgeon!) was successful and it’s a good thing because my knee has been through a lot and my hip has had to work extra hard to compensate. It has been a year and a half since the second FAI surgery and I am so, so glad I had it done. Good luck making your decision! You are wise to do your research.

 

[JoeKnows]

I was in a different, but similar situation. At 32, I was informed that I had AVN in my hip. Core decompression could provide some time (maybe), but replacement was inevitable.

They SAY replacements last 20 years or so, but the fact is the newest replacements haven't been around long enough to really have statistics. I understand the "managing expectations" part of things (I'm a lawyer, so I do the same), but even some of the older implants lasted way longer.

If you're gonna need a hip before 40, does it really matter if it happens at your age or 10 years down the road? With their time estimates, you'll need a revision anyway (as will I). My advice is don't make a decision based on guesses about how long the implant will last - make a decision based on whether a hip replacement will improve your life.

Edit: if you're wondering, I had some difficulty with my first hip for a while. AVN got my second hip in May of this year. I'm doing PT now mainly because I've met all my deductibles, so why not. I'm not the same as before symptoms began, but I coach soccer, wrestle with my dogs and kids, do yardwork... I don't regret it at all.

 

[Jaycey]

@KKJ18 Welcome to BoneSmart!

I really would not waste your time on reconstruction surgery. We have many members your age and younger who have had THR. Technology is on your side. Implants are lasting far longer these days.

JoeKnows has already given you input. Here are a few other stories from our younger members.
Dancing after THR: 4 months pics THR (this member is now Mum to 2 young children)
Here's a collection of threads on Teenage Hip Replacements

 

[CricketHip]

There's several great pieces of advice here for you to mull over @KKJ18 . I struggled for years with FAI and later a shredded labrum. I didn't compete but was an equestrian for my entire life, until very recently, NOT because of my THR's. We used to do long trail rides. 5-8 hours at a time and traveled to different states to enjoy difficult terrains, etc. It became so difficult to handle..
This may sound strange but I found dropping my legs out of the stirrups and riding that way was helpful, which wouldn't work in any way for competing.
So my sympathies are with you while you make the difficult decision.

I am in the the group that thinks a THR is the way to go. Wishing you the best in making your decision.

 

[Humbleservant]

@KKJ18 I am 19 months out of a left THR at 35 years old and returned as a police officer to unrestricted duty! I can tell you I’m so happy I did it verses the pain I was experiencing. I don’t even really feel like I had a thr and have zero pain! I work out and have 4 little ones to chase around and I do it with little/no issues! If you really need it, i know it’s scary to think about, but I highly suggest you strongly consider it! This group is one that was sooo helpful so stick around and pick our brains!

 

[JusticeRider]

I just want to emphasize too, the 6 yrs between my first and second FAI surgery, I I did not have a slow decline…8 months after my first surgery I did a 3 day 50 mile backpack in the Olympic Mountains in WA state in some of the most rugged terrain I’ve seen. I went on to do many more trips as well compete in multiple 50 and 100 mile endurance rides with no pain. Right up until my labrum tore again. My labrum was re-torn by being rammed by a goat (I promise I am not kidding). Now, since recovering from the other surgery I am pain free in my hip and can bend over and put both hands flat on the floor. I can’t say I’ve been hiking and riding much lately because of my messed up knee! But I just wanted to clarify that, lest you think I didn’t have lasting benefits from the first surgery. And if that surgeon had gotten all the impingement the first time, this hip could have lasted forever. Hopefully it will now! But the second time I really did my homework on finding the right surgeon, and I think that will pay off. Anyway, you’ve gotten some great perspectives from others here too, and maybe more still to come. You are doing the right thing investigating and informing yourself so you can make the right choice for you. Best of luck!