Patient Information Resources


Long Island Spine Specialists, P.C.
763 Larkfield Road
2nd Floor
Commack, NY 11725
Ph: (631) 462-2225
Fax: (631) 462-2240






Child Orthopedics
General
Pain Management
Spine - Cervical
Spine - General
Spine - Lumbar
Spine - Thoracic

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Our 14-year-old granddaughter has juvenile rheumatoid arthritis. Her left hip is frozen now so they are talking about doing a hip replacement. What should we know about this? We are trying to gather as much information as possible.

Age 55 used to be considered "too young" for a total hip replacement. Concerns about how long the implant would last, bone loss with future surgeries, and a high rate of complications often meant patients in pain just had to tough it out and wait. Now patients as young as 14 years old are having hip replacement surgery. There are many challenges and complexities involved with total hip replacement in young patients but the results seem to be well worth it. Most of these surgeries are being done for young adults who have severe hip damage or deformity. Such significant changes to the hip are mostly caused by osteonecrosis (bone death), osteoarthritis (usually the result of a previous injury), or juvenile rheumatoid arthritis. The goals of surgery are to relieve pain, improve motion, and restore function. One of the reasons total hip replacements are now possible in young adults has been the switch from cemented to noncemented implant (called component) parts. Cementless cups and heads means less bone is lost when removing the implants if and when they need to be redone after 10 or 15 years. Bone loss often means leg length shortening so this feature helps reduce leg length differences, too. A second reason results are better these days making earlier hip replacement possible is the advancement of surgical techniques. Minimally invasive approaches, muscle preservation, imaging studies to help identify structural deformities also help produce improved outcomes. If your granddaughter has had previous surgeries there can be scar tissue to deal with and the presence of other hardware (pins, screws, metal plates). You mentioned the presence of severe muscle and joint contractures (stiffness) as the reason for the hip replacement so we know that is a factor. Careful evaluation and pre-operative planning is advised (more than is needed for older adults who just have degenerative osteoarthritic joint changes). The surgeon must choose the best approach and implant possible for each patient. Sometimes this decision requires special imaging studies. Magnified X-rays, MRIs, and CT scans give the surgeon a three-dimensional (3-D) understanding of the joint angles, deformities, bone condition, and bone/joint size. Special thought and care goes into removal of previously used hardware before implanting the new hip joint. Patients can expect some bumps along the road due to the possibility of complications, which still remain high in many cases. But with today's more modern approaches, results are excellent.

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