Replacement Options for Younger Patients
Two large, new studies being presented this week at the annual meeting of the American Academy of Orthopaedic Surgeons (AAOS), in New Orleans, are offering new information on the best hip replacement options for younger patients with worn-out hips.
Total hip replacements have been performed on older patients for long enough now that doctors say the results are usually predictable, but less is known about the best ways to replace hip joints in patients who are younger, a group that is increasingly driving demand for these procedures.
In fact, one 2009 study projected that people younger than age 65 could account for more than half of all hip replacement patients as early as next year.
Because joint implant components wear out over time, younger patients often require what’s called a revision hip replacement surgery to replace the implant, or prosthesis.
Those second surgeries are complicated and often aren’t as successful because total hip replacement, the standard method of joint replacement, requires removing a significant amount of bone. Plus, the bone that remains has often deteriorated over time, making it hard to properly fit and anchor the replacement implant.
So a more conservative method of hip replacement called hip resurfacing, which was designed to preserve bone, has been gaining in popularity among surgeons who treat young, active patients.
Hip resurfacing is a bit like putting a crown on a tooth instead of pulling the tooth altogether. Instead of removing the top of the femur, including the ball that fits in the hip socket, and replacing it with a ball-and-stem implant, surgeons who do hip resurfacing reshape the ball of the joint and cover it with a metal prosthesis.
But now evidence is emerging that hip resurfacing isn’t always the best choice for younger patients.