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Cruisin' for a Hip Fusion

Hip fusion may be a good option for patients too young for a hip replacement. It relieves pain and restores function. The leg is a little shorter on that side, and the patient may walk with a limp, but most patients are very happy with the results.

In this study, doctors from the Joint Replacement Institute in California report on hip fusion as a treatment option. Their target group is patients 40 years old or younger. They point out who might be helped by the operation and who shouldn't have it. They offer some ideas about the importance of the patient-doctor relationship.

Technical ideas such as hip position, surgical planning, and methods of surgery are presented. The authors also give guidelines for care after the operation, and they point out when to use antibiotics, drains, and compression boots. Specifics of rehab and limits for the patient during the first six weeks are also covered.

Dr. Stover and his co-authors take the time to list and discuss various problems that can occur after hip fusion surgery. Some complications are more likely to occur early after the operation. These complications include blood loss, infection, nerve injury, blood clots, fracture, and failure to heal. Later on, problems are more likely to affect other nearby joints. Pain in the opposite hip, spine, or knee on the same side can limit the patient years later.

Finally, the authors discuss steps to take when changing a fused hip over to a hip replacement. This is called conversion. The benefits and problems with conversion are presented. The doctors conclude that hip fusion surgery is an excellent option for arthritic hips in young adults. The surgeon must take care to place the hip in a good position during the fusion. This will improve function, prevent deformity, and make conversion easier.

References: Michael D. Stover, MD, et al. Hip Arthrodesis: A Procedure for the New Millennium? In Clinical Orthopaedics & Related Research. January 2004. Vol. 418. Pp. 126-133.

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