Total hip replacement - How long does it last?

Question

My son is 16 and has a hip which cannot be repaired due to total slippage of the femural head. Some time between now and 15 years from now he will need a total hip replacement. It all depends on when his hip becomes painful.

If you have any personal experience please can you tell me what kind of replacement hip you had, nylon/steel, steel/steel, ceramic/steel or ceramic/ceramic. How long has it lasted since the operation, has it given you any problems and how old were you when the replacement was made.

I have read that nylon/steel are easiest to fit without complications but last up to 15 years and that ceramic/ceramic can potentially last a lifetime but are prone to fracture and have no long term testing statistics.

I would particularly be interested in a reply from anyone who has had a ceramic hip fitted long ago.

Answer 1

Even if your son waits 15 years, he will still be considered "young" for a hip replacement and will likely face at least one revision in his lifetime, and maybe more. Ceramic is relatively new so you will not find many people in the US who have had one for a long time, say over 20-30 yrs. It wasn't in general use that long ago. The concern of polyethylene is the wear issue:
http://totaljoints.info/polyethylene_for_total_hips.htm

This discusses bearing surfaces in THR:
http://totaljoints.info/bearing_surfaces.htm

Young males are particularly hard on their prostheses because they tend to be more active and beat up their hips. Older people are less active and are more likely to have their hips outlive them.

The most durable bearings would be either ceramic/ceramic or metal/metal. There are still some worries about metal/metal and the issue of metal ions in the body. See this on m/m
http://totaljoints.info/metal_on_metal_total_hips.htm
and this, on ceramic:
http://totaljoints.info/ceramic_total_hips.htm
and this, on metal/poly:
http://totaljoints.info/conven_thr.htm

Another option that has just become a reality in the US with the FDA approval of the Birmingham hip is resurfacing. Not every patient is eligible for this procedure and since it is fairly new in the US, you would have to locate a surgeon who does the procedure. It does have its detractors but its proponents claim that it gives the young patient a chance to postpone the total hip replacement and also permits them to engage in more vigorous activity and permits almost normal flexibility and ROM. It has been done in Europe for many years and many Americans traveled to get their hip resurfaced. I recommend these two links on the subject:
http://totaljoints.info/NICE_details.htm
http://totaljoints.info/surface_hip_replace.htm

There are alternatives to THR. These include fusion (which would allow the THR to be postponed although it does have its drawbacks) and are discussed here:
http://totaljoints.info/TH_alternative_operations.htm

As for me, I have had both of my hips replaced at age 58. They are 4 & 5 years old. The bearing surfaces are metal/poly.

Answer 2

The longer it takes for your son to have the THR, the better for him. THRs will not last a lifetime unless they were done in the 60s or 70s age group. Yet even in these age groups failures have been known to occur-it is not so much as due to faulty technique or implant failure but due to infection. Every orthopedic surgeon dreads an infected replacement procedure due to the difficulty in eradicating the infection. True enough, your son will definitely get degenerative arthritis in his hip due to the slippage of the femoral head. I just hope he gets this when he is at an age ideal for the replacement procedure.