Editorials

Young adults with arthritic hips

BMJ 1997; 315 doi: https://doi.org/10.1136/bmj.315.7103.265 (Published 02 August 1997) Cite this as: BMJ 1997;315:265

Should be offered alternatives to total hip replacement

  1. M D Northmore-Ball, Consultant orthopaedic surgeona
  1. a Unit for Joint Reconstruction, Robert Jones and Agnes Hunt Orthopaedic and District Hospital NHS Trust, Oswestry, Shropshire SY10 7AG

    Total hip replacement, about 40 000 of which are performed annually in the United Kingdom, is widely believed to be the only viable surgical treatment for arthritis of the hip. While total hip replacement is extremely effective for late middle aged or elderly patients, such that more than 95% of patients will probably die with their original implant in situ, the operation has limitations in younger people. The replacement has to last much longer, and young patients, unless restricted by some more generalised disease, tend to overload artificial joints with unrestricted activity. The long term results in this age group are therefore poorer, with several series reporting 25-30% of cases needing revision by 15 years (H Malchau, P Herberts, annual meeting of American Academy of Orthopaedic Surgeons, Atlanta 1996).1

    So, can anything else be done, and if so, when should patients be referred? Fortunately, there are several possibilities (M D Northmore-Ball, S R D'Souza, J Varughese, A M R New, meeting of European Hip Society, Helsinki 1996). Hips that fail early do so through secondary …

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