Alternatives to Hip Replacement

copyright 2000, Joint
Replacement Institute

Used here with permission�

There are alternatives to
total hip replacement surgery. Feel free to learn about the following
options:�

Conservative Management

One alternative is to not have an operation. If your pain can be controlled
with medication so that you are sufficiently comfortable and you are content
with your present activity level and motion in your hip, then you may decide
to wait.�

Femoral Osteotomy

For patients with developmental dysplasia of the hip (DDH), cutting the
thigh bone (femoral osteotomy) or pelvis (Chiari osteotomy) in order to
realign the hip may be indicated if the hip weight-bearing area can be
broadened or made more congruent. This is often useful in young patients.
Recovery following osteotomy may be longer than with joint replacement.�

Because of its known unpredictability, femoral osteotomy has been less
popular in the United States than in Europe, but it has the advantage of not
requiring artificial joint-bearing materials.

Arthrodesis

Arthrodesis is rarely performed, but is an especially effective procedure
for younger patients, particularly those who are of short stature and who
are otherwise healthy. “Arthrodesis” relieves pain by fusing the
femoral head to the acetabulum. It has none of the limitations that a joint
replacement or other procedure has in terms of restrictions on activity
level. If the patient’s back is mobile and without symptoms, it is a very
worthwhile procedure. The procedure generally requires internal fixation
with a plate and screws and occasionally cast immobilization while healing
takes place. An arthrodesis can be converted to a total hip replacement at a
later date.

Pseudarthrosis

A pseudarthrosis (Girdlestone operation) involves removing the femoral head
without any replacement. The procedure is performed for hip infections and
when the patient’s bone stock is inadequate for another reconstructive
procedure. This leaves the patient with a leg which is shorter and usually
less stable (although the changes are less apparent following a resurfacing
failure as compared to total hip failure). After this type of operation the
patient almost always needs to use at least one crutch especially for long
distance walking.