I am currently 17 years old, and I have a hip fusion. I am wanting a total hip replacement. I have quite a bit of lower back pain, but that's normal in a hip fusion. I have asked three doctors and two of them told me they wouldn't recommend it until I am in my thirties, but the other doctor told me that I would be able to have the surgery done as soon as I quit growing. One of the doctors told me there is a chance I wouldn't be able to walk again. I have read about having a hip fusion transferred into a total hip replacement on the Internet, and it sounds like my lower back pain will decrease and I will have more mobility if I have this surgery. Has anyone heard or experienced this and would they recommend having it done? I am having a hard time making my decision, and I would appreciate any advice. Thank you. ~Jessica

-- Jessica Richvoldsen (grneyedlady16@aol.com), June 29, 2001

Answers

Response to hip fusion to THR

It is difficult to give you a clear recommendation without knowing your past medical history, your general state of health, the reasons for your having hip fusion in the first place, and your x-ray appearance. However, in general, I would not recommend having a total hip replacement before growth has completed. A take down of a fusion to a total hip replacement is a fairly difficult operation, however, when done properly can have very rewarding results. It is quite possible that it would alleviate your low back pain and improve your function and mobility. However, hip replacements done in 17-year-olds almost never last for the life of the patient and, therefore, will require a revision procedure or, perhaps, more than one revision procedure during the course of your life. Also, patients who have had fusions do have a slightly higher rate of complications including dislocation or persistent limp. However if your symptoms and your current functional status are unsatisfactory, it certainly seems like it would be worth the risk. I hope this is of some help to you.

-- Marc W. Hungerford, M.D. (mhunger@jhmi.edu), August 13, 2001.

December 21, 2002

Hi Jessica, It was by absolutely mere chance that I came across you letter regarding your fused hip. I know exactly how you feel. I too suffered from having a fused hip for many years. Not only it gave me back pain but because I used fold my knee sideway when sitting, I ended up with a deformed knee and had to have a total knee replacement which had to be followed by a hip replacements. I dont think I need tell you about the discomfort in sitting, sleeping, driving or even standing straight in addition to the walking gait. Not knowing that it was possible to have a THR for a fused hip I suffered until my knee had to be replaced at the age of 70 while my hip was fused at the age of 25 at which time THR was not a recognized proceedure.It was not easy particularly the post operative period but that of course was on account of my age. The surgery itself was not bad but you have to be careful who to go to. You may have to wait until you are fully grown but absolutely plan to do it. Until then work on your muscles specially your abductors, as they are the ones you don’t use because of the fusion. Go to a good rehab center and have them draw up a PT program for you. This will shorten your rehabilitation period and you will stand a very good chance of walking normally. The prostheses they now use and the technique of a good surgeon is known to last up to 30 years. As to the question of the probability of revisions, deal with it at the time it comes up. Look for a surgeon who specializes in hip reconstruction. I am not a doctor but have had this problem for many years and have been examined in many countries and read a lot on this subject. Do not mentally and physically suffer in silence. The loger you wait the more it will take you to recover and the less will be the chance of satisfactory results. Please feel free to write back for any questions or moral support.

Merry Xmas.

Roushdybb

-- Roushdy Abouseda (rosha2000@yahoo.com), December 21, 2002.

Hoped you received my email of yesterday. Please note that my correct email address is "roshab2000@yahoo.com".

Regards, Roushdy

-- Roushdy Abouseda (roshab2000@yahoo.com), December 22, 2002.

My son had a hip fusion one year ago. He is 15 years old and has many of the problems that Jessica has described. He has a limp and limited mobility. He was in a body cast twice before the decision was made for the hip fusion. He had a unicameral bone cyst all other options were exhaused before the surgery. I was wondering since your e-mail was in 2001 if you have made any decisions? All information would be helpful for my son. Thanks Linda

-- Linda Czekanski (lcz@zoominternet.net), March 02, 2003.

37yo male with advaned staged denerative joint disease. I havnt had any procedure as of yet. My physician metioned a hip fusion. A hip fusion does not sound like a promising idea. I believe that you and I would be better off with a THR. There is the promise of better mobility and more of a normal gait. But, you should wait till you are finished growing. Although I am 20 years older than you I say go for it. Thank you for helping me make my decision.

Glenn

-- Glenn Stepnay (gdstepnay@yahoo.com), March 07, 2003.

Jessica, My name is Landon Henkelman, I am eighteen years old. I had a left hip fushion done last July. Then I went in again in November to have the operation done again as the first fushion didn't hold. I'm still walking with crutches so I'm still not experiencing near as much discomfort as you I'm sure. I do really miss the hip movement while sitting, sleeping, putting on socks etc. After reading your story and some of the replies I am a little sketchy as to what I should be looking foreward to. I am very interested in hearing about what I should be looking foreward to from your personal knowlage. It would be great to hear some upsides to the fushion (I hope you have some) E-mail me if you get a chance, Thanks, Landon Henkelman

-- Landon Henkelman (landon_henkelman@yahoo.ca), March 11, 2003.

Jessica, I have a 15 yr old son who is having severe pain in his left hip due to a condition called protrusio. His doctor has recommened fusion of the hip to help the pain. Like your doctor, he says we can consider a total hip replacement once he stops growing. Since my son has not had the surgery yet, I am curiuos to know if the fusion has made a significant difference in your life and do you suffer the resulting back pain daily. Thanks.

-- Glenda Penny (g1cent@aol.com), April 30, 2003.

Hi all, Sorry my e~mail address has changed and I had forgotten that I had written to this website. I have responded to some of the posts here. I still have lower back pain, but that is probably because I fractured it. Also, I still have a fused hip and I have just learned to live with it. The doctors said that they would not reccomend getting a total hip replacement, because the muscle in my leg isn't strong enough. So, if you decide to write me please write me at this address: GrnEyedLady720@aol.com. Thanks! :)

-- Jessica Richvoldsen (grneyedlady720@aol.com), May 03, 2003.

I had my left hip fused in 1963 when I was 13 years old. At the time THR was not recommended because the prosthesis had to be surgically cleaned every couple of years and I had my childbearing years ahead. I adapted well after the surgery and although I missed the mobility of a joint, I was pain free for many years and I was able to have three children normally. Eventually I began to have problems with my lower back and then my knees. Several years ago I asked about having a THR and was told by one doctor that I probably would never walk again because of muscle atrophy. A second doctor (experienced with undoing a fusion and replacing it with THR) said it could be done but recommended I wait until I was closer to retirement age since I was still functioning fairly well. This week I was told that I need double knee replacement. In addition, I cannot stand in one place for more than a few minutes without lots of back pain. I have been getting steroid epidurals in the spine for three years to help with the pain from the arthritis I now have in my back. I take pain medication daily and have moved from ibuprofen to vicoden. THR has improved a lot over the years so having the fusion transferred to a THR at a younger age would have saved me a lot of poin.

-- Jeanette Richman (jmrichman@yahoo.com), May 14, 2003.

I had hip dysplasia when I was younger and had several procedures done when I was 9-14 yrs. old. I got my first fusion when I was 12 and another when I was 14 since the first one didn't take. I am now 22 years old and have had very little problems with my hip. I used to have lower back pain, but since have been working out 2- 4 times a week and strenghthend my abs which helps a lot. I am almost fully fuctional except for limited range of motion and a small limp (one foot is 2 inches shorter.) When I had my fusion THR was not recommended because I was so young and they didn't last that long. So far I am happy with my fusion. I think weight and muscle maintence are a good idea to keeping you free of pain and discomfort.

-- Jennifer Onslow (nebulus912000@yahoo.com), May 20, 2003.

I had a hip fusion done exactly ten days before my fifteenth birthday in Toronto Sick Kids. I am now twenty-three soon to be twenty-four in a few short months and it only improved my wel-being and life for a year or so of the time. First of all the when the fusion was done my hip had been eating itself away for years and this was their last opinion. I only had the fusion done when a second doctor said that I should or will have a hip replacement after I was full grown. I seen my doctor in sick Kids for the last time in April and told me that he didn't recommend the replacement. I seen a new doctor who gave me an opinion back when I was 14 and he said that he is going to do the replacement and that he will actually set the date for the surgery when i see him again in Febraury. Having lived with a hip fusion for almost ten years I can tell you that i can't wait until the surgery. LIke many of you I have had problems with limping while I walk, sharp pains that I have nick named muscle spasms ( I have no idea if that is what they are but it sometimes hurts to breathe when they hit)and so on. Putting on socks let me put it this way thank goodness that I always hated them in the first place. Anyway when I seen this new doctor he did check my muscles so I think that it is a good idea to strengthen them some how. Well, when I see him in February if he gives me some new news or whatever I'll be sure to post it for you in case it helps in anyway.

-Jocelyn

-- Jocelyn Sinclair (contessica03@yahoo.com), September 19, 2003.

I'd like to know if there is anyone out there who have had a hip re- placement after having their hip fused with a cobra plate as I had and I was told I might never be able to get ahip re-placement as there might not be enough bone or muscle left as I am only 25 I'd like to think I might be able to get a hip replacement at some stage

-- Bill Cusack (billcusack@hotmail.com), September 29, 2003.