I'm a 29 years old male that will need a total hip replacement. I suffer from severe Rheumathoid Arthritis. Due to the RA and the high amount of prednisone that I have been taking for long time, my hips developed avascular necrosis. My question would be: In my condition and age what kind of hip prothesis would it be the best? I have heard about the ceramic hip prothesis that supoused to last longer and be stronger according to some. I talked to my orthopedist and he said that ceramic is not strong enough. whats is the truth? Please someone let me know soon. My surgery is coming soon.

-- GaryTello (x-evolution2000@comcast.net), February 17, 2004

Answers

Hi! I had a total hip replacement Jan 20. My doctor also recommended that I not have ceramic. His reasoning was that I was young (47) and active and the ceramic could chip or break. He used steel on steel. But the most important issue is the surgery itself. I think most doctors still do the posterior approach which cuts muscles, requires a longer incision, has more post operative restrictions, and requires longer rehab. I had an anterior incision, no muscles cut, only restriction other than pain was moving my leg backwards with my foot pointed out. Of course, the pain and stiffness kept me pretty limited, but a month later I can walk 30 minutes, no crutches but slowly. I still can't bend enough to put my sock on or tie my shoes, but that's about it. A friend here at work had the posterior technique and ceramic joint Dec 15 and was on crutches for about a month, and is still limping after 2 months, but he's doing great too. He's 42. Good luck to you!

-- Kris Carson (wisson00@aol.com), February 20, 2004.

You should visit this website: http://www.niams.nih.gov/hi/topics/hip/hiprepqa.htm

-- Robert Toussie (Robert Toussie @aol.com), March 15, 2004.

I know the Birmingham Hip resurfacing procedure is better for the youth. You might visit the website for your reference. www.midmedtec.co.uk

-- Shiu Yung CHAN (shiuyung_chan@msn.com), March 16, 2004.

Hey, Gary!

I'm a 45 year old male. I race bicycles and I used to run marathons, which is what destroyed my hip. I did tons of research on the Web, and decided that ceramic was probably the best option for me, since I intend to keep riding my bike about 5,000 miles/year. I went to two surgeons who wouldn't do ceramic. That business about ceramic not being "strong" enough is pure hoo-hah. Ceramic is harder than steel! But, it has to be installed properly, and the surgery is apparently more difficult to perform. A friend of mine, also a bike racer, had the conventional polyethylene-metal joint installed, and she wore hers out in four years and has to have it replaced!

I got the ceramic joint installed two weeks ago, and it's fabulous. My recovery has been incredibly easy, and I'm already back on my bike. Obviously, I don't know if the thing is going to fail soon or not, but the best statistics I could find indicate that one in 25,000 ceramic joints will break. Those odds are good enough for me, since I know that ALL polyethylene joints will wear out within 20-25 years. The question for you is, do you really want to have MORE surgery when you're 50? I hope your able to find a good surgeon with some experience with ceramic. It's relatively new in the USA, but they've had over 20 years of success in Europe with them...and today's product are better.

Good luck, and God be with you! That Prednisone is bad stuff. I hope you have some good results!

-- Glenn Wright (gwright@bha.com), March 30, 2004.

I was diagnosed with hip dysplasia (from birth) when I was 25 years old. I am now 30 and have had both my hips replaced. I had a THR on the right two years ago and am doing very well with that hip. I had the THR on the left about a month ago. The first surgery that I had was the traditional, 12-inch incision. I dislocated the hip two days after getting out of the hospital. That surgery took a good four months to completely heal to where I could walk without assistance of a cane. This second surgery, I had the new MIS 2-incision hip replacement and it has been wonderful. They do this procedure through 2 two-inch incisions (one near the groin and one on the side) and there is no cutting of muscles, tendons, or ligaments. They are able to access the joint by separating the muscles. There has been less pain and a quicker recovery of this recent surgery. There are also less precautions and less chance of dislocation. I was off narcotics and out of bed the day of the surgery! Being a month out from surgery, I can walk on my own around the house and for short distances. I still need the cane for long walks, but I should be off that in a week or so. I would highly recommend researching this procedure for anyone that needs a THR. It has been wonderful. The website to research this or to find a doctor in your area is www.pacewithlife.com.

Good luck!

-- Sonya Luther (sonyal123@hotmail.com), April 13, 2004.