Hip surgery in young adults: why you're never 'too young' for a replacement

Hip replacement surgery may be necessary to replace your damaged hip joint.

We spoke with leading consultant orthopaedic surgeon, Mr Seb Sturridge, to learn more about hip replacement surgery. Read on to find out how a wide variety of patients of different ages can benefit from this procedure and what the latest innovations are.

How young can someone be to have hip replacement surgery?

Hip replacement surgery can be considered at almost any age in an ambulatory patient, but we try to delay surgery in children until they are skeletally mature. In my practice, I see some teenage patients with developmental abnormalities of their hips or who have had treatments for other conditions which have resulted in damage to their hip joints to the extent of needing to consider hip replacement surgery. Most young adult patients considering hip replacement are between 20 to 50 years, and are considering surgery to maintain their ability to continue in education or work, or care for their children.
 

Why do you think more and more young people are having hip replacement surgery nowadays?

Hip replacement implants have significantly improved over the last 60 years and are now performing better and lasting longer than ever before. Less invasive surgical techniques enable safer surgery with a faster recovery and return to work, and higher functional outcomes. As the technology has advanced, surgeons in the orthopaedic community feel more confident offering this type of surgery to younger patients. Beyond primary hip replacements, revision hip surgery for patients whose implants have worn out or become loose has also rapidly advanced.
 

Are a lot of hip replacements in the younger generation due to sports-related injuries?

Over the last 20 years, we have developed a much better understanding of the forces that hip joints are exposed to and how they can damage a hip joint. Most young adults developing early arthritis have a hip joint shape which puts them at higher risk of injuring their hips earlier, and this can be accelerated by playing higher impact sports. We now offer patients presenting earlier in the degenerative process day-case keyhole hip surgery to debride or repair damaged hip cartilage (labral tear), and change the shape of the hip joint to reduce the risk of reinjury.
 

What are the benefits of hip surgery in younger people?

Joint preserving hip surgery in younger patients may be necessary to manage pain to be able to work, exercise or look after your children. Beyond activities of daily living, surgery may enable them to continue with a particular sporting interest. Younger patients are usually fitter for surgery, and so recover and rehabilitate faster - no matter what level of intervention is necessary, they generally go on to achieve a better functional outcome.
 

How has technology advanced in treating the hip?

Technology has advanced our understanding of how hips are damaged, at what stage to intervene to best improve pain and function, and less invasive techniques to improve pain and delay further damage. Surgery is less invasive, so recovery and a return to work is much faster. Implant design has improved in terms of the way they bond with bone and the bearing surfaces so that they last longer, again delaying the need for further surgery. We hope to see successful hip replacements using current technology to last 40 years.
 

How long does a hip replacement last and is it likely going to need to be replaced in younger patients?

I tell patients that some older implants with metal on polyethylene bearings are lasting 30 years or more. Newer uncemented implant designs with modern ceramic bearings should last longer, but have not been available long enough yet to demonstrate this. However, implants are also being exposed to greater forces as patients return to a much higher level of function and sports after surgery. I advise patients to consider mainstream standard implants which have been on the market for a number of years and have demonstrated that they last a long time; and to look after their implants and avoid excessive high-impact exercise. But more importantly, choose an experienced surgeon!
 

To determine whether a hip replacement is the right procedure for you, you may like to chat with a highly experienced consultant orthopaedic surgeon such as Mr Seb Sturridge.