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When I was a child, I had a hip problem called Perthes. My parents were very conservative and didn't agree to a lot of the surgery that was recommended for me. That has had its advantages and disadvantages. Now I am 35-years old and have severe hip osteoarthritis. I understand I could be a candidate for a hip replacement. What can you tell me about this?

According to a report from Italian orthopedic surgeons, hip replacement in adults who had Perthes disease as a child is technically challenging and difficult. But the procedure is entirely possible and good results can be expected! In this study, the average age at the time of the hip replacement was 37.8 years. Patients included were as young as 19 up to 65 years old. The surgical success rate was impressive with 96.9 per cent implant survival after 15 years. Test scores for hip function were much improved from before to after surgery. There were some complications with an overall complication rate of 12.5 per cent. Most of the post-operative problems occurred as a result of the procedure itself. There were two patients who developed permanent sciatic nerve palsy when the involved limb was lengthened surgically. One patient had a hematoma (pocket of blood) that had to be drained surgically. And the femur (thigh bone) fractured in one other patient as the implant stem was being placed down inside the bone. The authors concluded that hip replacement in adults who had Perthes disease as a child is possible. That's good news for those who develop severe, disabling hip arthritis in their early adult years. As the study showed, it requires experience and expertise on the part of the surgeon to perform this procedure. Much preoperative planning goes into a procedure like this. Careful examination of the patient and evaluation of imaging studies (X-rays and CT scans) is required. Patients face some risks of complications but if the people in this study are any indication, most will be satisfied with the reduced hip pain and improved hip function.

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