YOUR HEALTH: Replacing hip replacements

CHICAGO – 21-year old Ashley Frankenthor has spent most of her young life on the move.

"I played soccer, softball, I did gymnastics, cheerleading."

Her favorite sport turned out to be volleyball.

"I was very competitive and like always needed to be aggressive."

But hip pain sidelined the promising athlete in high school.

"I was in so much pain, where I could not walk or do anything."

It took a few years, but Ashley finally got a diagnosis. She had hip dysplasia; or an abnormal hip joint.

Doctors don't know what causes it, but if untreated, it can lead to severe arthritis.

"And once a hip is arthritic, really the only treatment is a hip replacement," explained Dr. Joel Williams, orthopedic surgeon with Midwest Orthopaedics at Rush University Hospital in Chicago.

The problem is hip replacements only last about 20 years for elderly patients, but as many as 35 percent of patients younger than 50 have to do it again in five years.   So young patients like Ashley would either have to wait in pain for years or have the surgery and multiple revisions.

"And each time that a hip replacement is revised, the outcomes are not as good," warned Dr. Williams.

Dr. Williams offered Ashley a different option; hip preservation surgery.   He essentially cut her pelvis and shifted her bone up, so the hip joint aligned with the socket.   It can postpone or even eliminate the need for a hip replacement down the road.

The recovery hasn't been easy, but Ashley says it's worth it.

"I feel like a whole new person after it."

TREATMENT: There are non-operative treatments that include weight loss, joint injections, physical therapy, and lifestyle changes. Non-operative treatments are for those with mild symptoms.  Arthroplasty is a joint replacement surgery that uses artificial parts to replace the damaged joint. A total hip replacement happens when the dysplasia is too severe, and is determined by the status of the cartilage surfaces. If the cartilage starts to wear out, then it is time for a total hip replacement.
(Source: http://hipdysplasia.org/adult-hip-dysplasia/adult-treatments/ )

PERIACETABULAR OSTEOMY: Periacetabular osteotomy or 'PAO' is when the hip socket is cut from the rest of the pelvis and rotated into a normal position. This results in a normal alignment. This type of surgery is performed to postpone a hip replacement. PAO is a better option if the cartilage surfaces are normal, or near normal. It`s also a better option for younger patients with hip dysplasia. Hip replacements last 20 or more years in older people, but fail much earlier in young and active patients. As many as 35 percent of patients under 50 would need a second operation within 5 years if they chose to have total hip replacement at an earlier age, even with the PAO. Overall, the PAO surgery is low risk and a continuous passive motion (CPM) machine is used to assist joint healing after the surgery.
(Sources: http://clohisyhipsurgeon.com/treatment-options/periacetabular-osteotomy-pao-for-acetabular-dysplasia)

If this story has impacted your life or prompted you or someone you know to seek or change treatments, please let us know by contacting Jim Mertens at jimmertens@wqad.com or Marjorie Bekaert Thomas at mthomas@ivanhoe.com.