This is also called an “arthroplasty” and uses artificial parts to replace the damaged joint. The two main categories of hip replacement procedures are:
Your surgeon will discuss which option is best for you and the anatomy of your hip joint.
Hip Resurfacing
For younger, active patients with relatively normal anatomy, hip resurfacing offers a less invasive, bone preserving option because less bone is removed to perform the surgery. However, hip resurfacing is not always the best option for patients with hip dysplasia.
A study from Australia has shown a higher revision rate when resurfacing was performed for patients with dysplasia. [2]
For women of child-bearing age there is a theoretical concern that metal-on-metal resurfacing creates metal ions that could affect a baby's development in the womb.
Total Hip Replacement
When the dysplasia is more severe, or the patient is older, then a traditional total hip replacement is usually performed.
Special techniques are often required for arthritis from hip dysplasia because the socket is shallow, or the joint may be dislocated which may have muscle shortening and changes that extend into the soft tissues. Bone grafting of the socket or shortening of the femur may be needed to restore more normal hip anatomy and avoid nerve complications from excessive stretching of the soft tissues.
Such hip replacements can be complex and require very experienced operative teams and centers experienced in complex hip surgery.
Salvage procedures in young patients
Two procedures that are rarely used today are the Colonna Arthroplasty and the Girdlestone Procedure. These two procedures have largely been replaced by hip re-surfacing procedures.
Hip fusion is also a last resort where the hip joint is removed and the bones are secured together. This procedure eliminates hip motion, but it relieves pain and is surprisingly well-tolerated for sitting, walking and light sports.
One alternative to hip fusion in extreme cases or in underdeveloped regions is called a “pelvic support osteotomy”. In this procedure the femur below the hip joint is realigned severely to shorten the leg and place it in a better position to relieve pressure on the hip joint.
Complications
Complications are more common for hip replacements in patients with severe dysplasia when compared to routine hip replacements in non-dysplastic patients. Your surgeon can discuss all the risks and benefits of surgery specific to your hip problem. Fortunately, the vast majority of patients obtain predictable pain relief and a durable hip replacement. Periodic x-rays after surgery are performed, usually yearly, because hip replacements may wear out over time, or loosen and need revision.
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