Young patient -26 Need Advice!

[YoungM]

I recently joined this board and have been reading through the threads, receiving some valuable insight. Thanks everyone!

I developed arthritis in my right hip at age 21 and have been dealing with this for 5 years now. I've seen several doctors and all have concluded there is no reason other than "unknown" as to how/why I developed arthritis or AVN so young. All possible reasons were ruled out.

I have finally decided it's time for THR. Unfortunately, I need a THR and can not benefit from hip resurfacing, as I have a large cyst and am not a candidate for resurfacing. Since I'm only 26 and plan on having children within the next several years, I will be getting cement on cement (rather than metal).

Anyone else on this board my age? I'm concerned with how long the hip will last for. I was trying to put it off and get the surgery years from now, but why live my youth in pain when I should enjoy these years now? Right?

 

[JudyS]

YoungM
I am just about twice your age. You will find there are young people with replacements your age. YOu may have to read through the thread titles as they do not post on a regular basis.
One is young guy.
My doc expects my replacement to last over 30 years. I am very active, possibly the most active patient he has.
As far as materials. Cement is one of the types of ways to implant the prosthesis. The other type is non cemented, more of a press fit where your bone grows into the prosthesis.
I have a ceramic ball/ highly cross-linked poly cup. It is an excellent surgery, my hip is awesome. There is some debate about the metal parts and ions, this may be what a doc was referring to for you as you plan on having children.

I hope some young people find your post. Sounds like you have been doing some research and our wonderful nurse, Josephine will be helping you soon.
Judy

 

[YoungM]

Judy thanks so much for your reply and sharing your story! I'm glad to hear you were given a long expectancy for your hip. It's comforting to hear other's experiences. I'm looking forward to other posts.

Correction: I will be getting ceramic/ceramic (not cement on cement). Can you tell I'm a bit nervous about this?

 

[LuvANurse26]

Hi YoungM,

I'm a 30 year old female. I'm a nurse, and I met my doctor 5 years ago by working with him on a daily basis. I have been dealing with AVN since I was about 12 years old. I've had about 4 other surgeries during my pre-teen and teen years. I finally came to the conclusion of going on and having the hip replacement. I had it done on Oct 28th. I too like you do not have any children. I do plan to have children one day. My doctor chose a metal on plastic (poly) prosthesis for me knowing that I plan to have children in the next couple of years. He didn't wanna go with the ceramics just because of risks of it breaking. I don't think that happens much. But, with my luck, I would be the one. You will find that all doctors will recommend something a little different.

He expects this hip to last me at least 20 years. He told me not to guard my hip, and to live my life. Its good that you decided to go ahead and do it. I put it off for year because other doctors told me I was too young. But, I would rather have a better quality of life now. I wish that I had mine done in my 20s, but better late than never. I walked with a limp for years, and now I'm walking straight. My confidence is so boosted.

I could go on and on. I'm glad to have found another person on this site close to my age. I usually check the site on a daily basis. If you have any questions, don't hesitate to ask me. Good Luck.

 

[JudyS]

As LuvANurse said, different docs will have opinions on techniques as well as prosthesis. There is a great thread on how to choose a surgeon with questions to ask.
When I found this forum , I already had a great surgeon. I went with his recommendations and preference for surgical technique. If you are kind of active, I was able to swim at 3 weeks post op which helped tremendously in getting range of motion better than pre surgery.
A suggested question to ask your surgeon. Mine suggested ceramic/ceramic in Jan when we met. When I decided to get the replacement it was April and he had changed his recommendation based on the possibility of ceramic/ceramic squeaking. There is a thread about noises with hip replacements. He attributed it to the ceramic components, so went with ceramic/poly. The newer ceramic is not supposed to have the breakage/shattering problem. He talked to me about that with the older ceramics.
I obviously can go on forever.
Off to bed
Judy

 

[Josephine]

Well, there have been reports of hips lasting 40 years and more. There's one here 40 years life span for a hip replacement!! and that was using an old, old hip prosthesis! Truth is, the majority last a lot longer than 'predicted norms' which is good. It's a shame about that cyst.

However, some years back I worked with a surgeon who specialised in dealing with young adults - Perthes, CDH and AVN. We often put THRs in folk as young as 19. His philisophy was as you say, why waste their lives when they can have some kind of restoration of quality of life?

There's is a forum dealing with noises from ceramics but though we expected lots of input, turns out there wasn't much! Noise Related to Total Hip Replacement - The Experts Speak Out

 

[YoungM]

Thanks everyone for your responses -much appreciated.

LuvANurse: You mentioned that you went with metal on plastic (poly) prosthesis since you plan on having children. Is their any threat of the metal on plastic?

I don't want a squeaky hip at all! That is a concern. My doctor explained that the ceramic/cermaic was the best choice for me. He stated the metal was more durable, but the ceramic is not too far off.

 

[LuvANurse26]

To be honest, I'm really not that sure. If I recall he said that he hasn't found any information that gives knowledge on the "metal ions crossing the placenta." He said something about with metal on metal that the metal gives of ions in the body over time. I know I'm not quoting him exactly. But, he assured me to go ahead and "have my babies", and I plan to just that.

 

[YoungM]

That is great. So you are about 2 months post op? How are you doing?

 

[LuvANurse26]

I'm doing very well. Every week I can tell I feel even better. Wish I could tie my shoes, but from reading this forum that will come with time.

 

[jaz]

To be honest, I'm really not that sure. If I recall he said that he hasn't found any information that gives knowledge on the "metal ions crossing the placenta." He said something about with metal on metal that the metal gives of ions in the body over time. I know I'm not quoting him exactly. But, he assured me to go ahead and "have my babies", and I plan to just that.

My OS told me there was no evidence either way but he liked to play it safe and not put in metal on metal to women of child bearing age.

 

[LuvANurse26]

I've learned as a nurse that all MDs are different and have different views on issues.

 

[aluminaman]

Hey Buddy,
I feel your pain! (literally) haha
I am 23 years old, I have one THR done already, and am waiting (saving $) for the next one. I went to Bangalore, India for my first THR because I do not have health insurance, and might go back for the second. (Which inconsequently also meant I had to handle the setting up and alot of coordination for my surgery + stay)

I had my first THR done on Thanksgiving 2007, so I just passed my 1 year anniversary with my new parts! My surgeon and I decided on ceramic/ceramic because of the risk of metal ions floating off in my body.
This was an issue for me because I have a chronic kidney disease, and so only have roughly 60% kidney function. Bad kidneys + ions = not good.

I also had AVN, due to either a combo of prednisone (steroid) and deficiency from the CKD, not really sure of the cause. All i know is it's been hell to walk/limp, use a cane, etc when we're as young as we are.

This past year i've never had any problems with noises/squeaking and the ceramics. The closest thing that I get to any grinding/noises is when I bend way too far over like tying shoes sitting down, or anything that requires an extreme bend. I'm 6'3'' and have really long legs, so right when I bend to far and I feel it grind, I just have to sit back up and it's no big deal.

Also, I did get American made parts. Brand new DePuy!

 

[Josephine]

Welcome to the forum, aluminaman. Like your name!

 

[Ginny]

Hi,

I'm 36 yr old female, had THR a year ago Jan 14th at UAB in Birmingham. I haven't had children, so we discussed the cement option, but my Dr. decided the metal on metal would be better for the long run.

I'm doing SO MUCH BETTER! Trust me, you will feel so much better. The initial post op (4 days) in the hospital were a challenge, don't get me wrong, it's painful, but every day you'll get stronger and better.

I recommend getting a higher-rise toilet installed, I went to Home Depot an had a friend change out my toilet with a higher rised one. It's very nice, I also recommend going to a medical supply store and invest in the hand rails for the toilet, bath/tub seat, reacher tool and sock tool. You'll need these for sure.

Let me know if you have any questions.

All the best!
~Ginny

 

[mssully]

When is your surgery scheduled?
My understanding is the risk of ceramic shattering is during the implant process. I have a metal on metal, my doctors recommendation. I am not as young as you, but was hit by a car when I was nine years old. Don't wait if you have done everything you can do like proper exercise, watching your weight etc. and nothing is working to help your pain. The rest of your body (back etc.) can suffer while you are "out of whack" limping etc. Good luck in what ever you chose. Let us know how it goes for you!

 

[Josephine]

Ceramic rarely shatters during the op. Cases reported have been up to a year post op.

 

[YoungM]

Thanks for sharing your story, Aluminaman. Nice name! Glad to hear the surgery and ceramic is working pretty good for you.

Josephine -are there many reported cases of ceramic shattering?

 

[Josephine]

Actually no but some time back there were sufficient cases for the industry to do a lot of research and the current type of ceramic used is, I believe, less likely to shatter than that used 10-15 years ago. I always look at it like this - if it's a significant problem and the surgeon knows that, he would be open to litigation for using a product with known problems. This would be an issue that would affect their entire livelihood. Therefore, having ensured his credibility was of high repute, any implants he (or she!) used would be accceptable to me.

Just as a humerous side note, I have ceramic floor tiles in my kitchen - they used to be infamous for shattering if you dropped so much as a kitchen knife on them! Not so now!

 

[JudyS]

I have a ceramic ball, my surgeon told me the horror stories of an older generation of ceramic shattering. he knows I am extrememly active and a clutz, but choose a ceramic ball for me. The cup is the highly cross linked poly as he thought the ceramic on ceramic cup has the squeaking possibility.

He was amazed at the excellent range of motion I regained quickly. A lot better than my good side!!! I attribute that to swimming at 4 weeks. The frog leg kick to be specific.
Judy