All you need to know about hip replacement in young adults

Normally, we think of hip replacements being used to treat hip arthritis in elderly patients, however, the procedure is now becoming more common in the younger, sporty generations. We’ve asked one of our expert orthopaedic surgeons Mr Adam Cohen just how young can someone be to have a hip replacement, the reasons why and what lifestyle changes may be necessary following surgery.

What is the youngest age that someone can have a hip replacement?

The youngest patient that I have performed a hip replacement on was 20 years of age. We obviously try to avoid doing hip replacements on such young patients.
 

What causes young adults to need hip replacement?

Young adults who require hip replacements generally have had a problem with their hip when they were very young. Examples of these types of problems include perthes disease, hip dysplasia, fractures and infections.

Adults in their 30s can develop a problem called femora-acetabular impingement which can predispose those patients to develop degeneration of the cartilage, which can become full-blown arthritis eventually.
 

Are some hip replacement options better for younger patients than others?

Generally speaking, a patient who is young requiring a hip replacement needs the hip replacement to last as long as possible. I tend to use ceramic-on-ceramic heads with uncemented implants.

In addition, it is better to try to save as much of the bone as possible and so I am inclined to use shorter (bone conserving) implants when possible. The reason for this is that if the hip replacement subsequently needs revising after a number of years there is more bone available in order to fix the revision implant. Hip resurfacing is an example of a bone conserving implant.
 

What are the risks and benefits of having hip surgery at a young age?

The main risk of having a hip replacement done at a young age is that at some point it will have to be revised (redone).

Obviously there are all the normal potential risks of hip replacement surgery i.e. Infection, deep vein thrombosis, damage to nerves or blood vessels, dislocation, leg length discrepancy, fracture of the bone during surgery, stiffness and swelling.
 

Will young patients need to make lifestyle changes before/after hip replacement?

Patients don’t need to make any general lifestyle changes but losing weight if you are overweight and stopping smoking are important. If you are diabetic then getting your diabetes under good control is important as this may increase your risk of infection if it is not under control. 

After surgery, for the first four weeks, patients need to progress themselves under the care of a physiotherapist and not rush their rehabilitation. Most patients can fully weight-bare immediately after their surgery but the confidence to walk without any crutches takes a few weeks.

Being able to drive after the surgery depends on the ability to be able to drive safely and be able to stop the car in an emergency. In my experience, this usually occurs between four and six weeks.
 

When can a patient return to playing sports?

In younger patients who often play sport, the ability to return to that sport depends on the type of sport. Returning to cricket, tennis or golf can be achieved after three to four months. 

Playing football would normally require six months and would need to be a guided return depending on the level being played. 

Essentially, running and other sporting activities is possible after hip replacement but the risk is that the implant will not last as long as it might have done.

Do not hesitate to book an appointment with Mr Cohen now via his Top Doctor’s profile here.