Is Hip Replacement the Only Option for Hip Joint Issues?

Is it only possible to replace with a hip prosthesis?

Hello! I have soft tissue damage in my hip joint.
I underwent hip arthroscopy in February of this year, but the pain has worsened.
In May, I paid for shockwave therapy, which seems to have provided some improvement, but the condition fluctuates.
On rainy days, the pain can be so severe that I am unable to walk.
My current situation is as follows: 1.
Congenital hip dysplasia 2.
Ruptured round ligament 3.
Severe cartilage wear 4.
Partial dislocation of the femoral head.
Doctor, is there still hope for my hip joint? Thank you!

Ms. Hsieh, 40~49 year old female. Ask Date: 2020/06/10

Dr. Cai Shanglin reply Orthopedics

A diagnosis cannot be made based solely on the symptoms; imaging assistance is required.
It is recommended to visit an outpatient clinic for evaluation.

Reply Date: 2020/06/10

More Info

When considering hip joint issues, particularly in the context of your diagnosis, it is essential to understand the various treatment options available beyond just hip replacement surgery. Your current situation, which includes congenital hip dysplasia, ligament tears, severe cartilage wear, and femoral head subluxation, indicates a complex condition that requires a comprehensive approach.

1. Understanding Your Condition:
Your diagnosis suggests that you have significant structural issues with your hip joint. Congenital hip dysplasia can lead to abnormal joint mechanics, which may contribute to the wear and tear of cartilage. The torn ligament and the subluxation of the femoral head further complicate the situation, leading to pain and functional limitations.
2. Non-Surgical Options:
Before considering a total hip replacement, there are several non-surgical interventions that may provide relief and improve function:
- Physical Therapy: A tailored rehabilitation program can help strengthen the muscles around the hip, improve flexibility, and enhance overall joint stability. This may alleviate some pain and improve mobility.

- Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) can help manage pain and inflammation. In some cases, corticosteroid injections into the hip joint may provide temporary relief.

- Weight Management: Maintaining a healthy weight can reduce stress on the hip joint, potentially alleviating pain and improving function.

- Assistive Devices: Using a cane or walker can help offload weight from the affected hip, making it easier to move around and reducing pain during ambulation.

3. Minimally Invasive Procedures:
Given that you have already undergone arthroscopy, you might consider other minimally invasive procedures. These could include:
- Hip Joint Injections: Injections of hyaluronic acid or platelet-rich plasma (PRP) may provide symptomatic relief and improve joint function.

- Osteotomy: In some cases, realigning the bones around the hip joint can help redistribute weight and relieve pain. This is particularly relevant for patients with hip dysplasia.

4. Surgical Options:
If conservative measures fail and your quality of life is significantly affected, surgical options may need to be considered:
- Partial Hip Replacement: If the damage is localized to the femoral head, a partial hip replacement might be an option, preserving more of your natural anatomy.

- Total Hip Replacement: This is often the last resort when other treatments have failed. While it is a more invasive procedure, it can provide significant pain relief and restore function. Given your age and activity level, a well-placed prosthesis can last many years, but it is essential to weigh the risks and benefits.

5. Long-Term Considerations:
It is crucial to have realistic expectations regarding the outcomes of any treatment. While hip replacement can be life-changing for many, it does not guarantee a return to pre-injury levels of activity, especially in younger patients who may require revision surgery in the future.

In conclusion, while hip replacement is a viable option for severe hip joint issues, it is not the only one. A multidisciplinary approach involving physical therapy, medication, and possibly minimally invasive procedures should be explored first. If these options do not yield satisfactory results, then surgical intervention may be warranted. It is essential to have a thorough discussion with your orthopedic surgeon about your specific condition, treatment goals, and the potential risks and benefits of each option.

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