Associated With Degenerative Hip Disease
Up to 5% of adults may have a history of a hip disorder during childhood. Certain childhood hip conditions are associated with degenerative hip disease that may ultimately benefit from hip replacement surgery. These conditions include:Â
- Hip dysplasia
- Slipped capital femoral epiphysis (SCFE)
- Perthes disease
When it comes to hip replacement for patients with a history of these conditions, the surgery often requires special techniques and implants to accurately reconstruct the hip joint. Dr. Alexander McLawhorn has particular expertise in treating patients with these conditions in his offices in New York City and Stamford, Connecticut.
How the Hip Joint Works
The hip joint is where the head of the thigh bone – the femur – meets the socket part of the pelvis bone – the acetabulum. The joint creates a ball and socket, where the ball is the head of the femur. Articular cartilage, which is tough, covers both parts to protect the bones and ensure they move smoothly as you walk.
Signs of Hip Issues in Toddlers
Some general signs of a hip disorder include hip pain or aches, hearing or feeling the hip click as it moves, hip pain during physical activity, trouble getting out of a vehicle, difficulty lifting the leg, and difficulty putting on shoes and socks.
Types of Childhood Hip Disorders
Childhood hip disorders affect how the hip joint develops and functions. Early diagnosis and treatment can help manage these conditions, but some may still cause long-term joint problems into adulthood. Here are some of the most common types of childhood hip disorders:
Hip Dysplasia:
- Hip dysplasia refers to the abnormal development of the hip joint, where the socket is too shallow to fully cover the ball portion of the upper thigh bone (femur).
- This condition can occur during infancy or childhood and, if left untreated, may lead to chronic hip pain, instability, and eventually degenerative changes within the joint.
- While early diagnosis and treatment with methods such as bracing or surgical interventions can improve outcomes in children, some individuals may still experience long-term consequences, including degenerative hip disease.
Slipped Capital Femoral Epiphysis (SCFE):
- SCFE is a condition where the femoral head (the ball-shaped end of the thigh bone) slips backward relative to the neck of the femur through the growth plate.
- It typically affects adolescents during periods of rapid growth, particularly overweight children.
- SCFE can cause hip pain, limping, and restricted movement. Moreover, it may predispose individuals to early-onset osteoarthritis due to altered hip mechanics, hip impingement, and increased stress on the joint surfaces.
Perthes Disease (Legg-Calvé-Perthes Disease):
- Perthes disease involves the temporary loss of blood supply to the femoral head, leading to osteonecrosis and eventual deformation.
- It primarily affects children aged four to eight years and can result in hip pain, stiffness, and difficulty walking.
- While many children with Perthes disease eventually recover with proper management, some may develop residual deformities or hip joint abnormalities that predispose them to degenerative changes later in life.
Why Childhood Hip Issues Increase the Risk of Degenerative Hip Disease
Degenerative hip disease, also known as hip osteoarthritis, occurs when the cartilage in the hip joint wears down, leading to pain, stiffness, and reduced mobility. While this condition often develops with age, individuals who had childhood hip disorders may experience it earlier due to lasting changes in joint structure.
Conditions like hip dysplasia, SCFE, and Perthes disease can affect how the hip forms and functions, placing uneven stress on the joint. Over time, this added strain can accelerate cartilage breakdown, increasing the risk of arthritis and joint deterioration.
Total Hip Replacement for Adults with Childhood Hip Disorders
If you had a childhood hip disorder, you may need a total hip replacement earlier than most people. Because your hip developed differently, the surgery requires a customized approach for the best results.
We begin with a thorough evaluation, using X-rays, MRIs, and possibly 3D imaging to assess your hip structure and plan the surgery.
Surgical Procedure
After administering anesthesia, we make an incision to access the hip joint. We remove the damaged femoral head and worn cartilage, then secure a prosthetic socket (acetabular cup) into the pelvis. We insert a metal or ceramic ball on a stem into the thigh bone, ensuring a smooth joint.
If the hip socket is too shallow or misshapen, we reshape or reinforce the bone to improve support. In cases of bone loss, we use bone grafts or specialized implants to rebuild the structure. We also adjust soft tissues around the hip to improve movement and stability. Once the new components are in place, we test the joint for proper alignment and range of motion before closing the incision.
Recovery After Hip Replacement
Most people stay in the hospital for one to three days, and you’ll start moving within hours to prevent stiffness. For the first few weeks, you’ll use a walker or crutches while your hip heals and you start physical therapy to rebuild strength and balance.Â
Pain will be the worst in the first few days, but you can manage it with medication, ice, and gentle movement. You’ll still feel sore for a few weeks, especially during activity, but it will gradually improve.
Over the next six to twelve weeks, you’ll regain mobility and start walking without assistance. Most people can return to light daily activities within six weeks, though you may still have some stiffness and fatigue.Â
Full recovery takes six months to a year, depending on how much damage your hip had before surgery. Long-term, you should feel significantly less pain than before, and it should be easier to move around.Â
Challenges in Hip Replacement for Adults With Childhood Hip Conditions
Adults who had hip problems as children often have unique challenges when they need hip replacement surgery. These differences in hip structure and function require special techniques to ensure a successful outcome.
- Differences in Hip Shape:Â Many people have hips that did not develop normally, such as a shallow hip socket, a misshapen hip joint, or misalignment. Surgeons must carefully plan the procedure to make sure the new hip fits properly.
- Scar Tissue and Stiffness:Â Previous surgeries or long-term hip issues can lead to stiff or tight tissues around the joint. This can make surgery more complex because the surgeon may need to release or repair these tissues.
- Weaker or Misshapen Bone:Â Some childhood hip conditions cause bone loss or irregular bone growth. In these cases, surgeons may need to use bone grafts or custom-made implants to ensure the replacement joint stays secure.
- Specialized Implants:Â Standard hip implants may not work well for patients with past hip conditions. Specially designed implants can improve stability and the lifespan of the new hip.
- Longer Recovery and Rehabilitation:Â Because of muscle weakness or changes in the way a person walks, physical therapy is especially important after surgery. You will need a tailored rehab program to help strengthen the hip and restore movement.
- Ongoing Monitoring:Â Patients with a history of childhood hip conditions may need more frequent follow-ups to check for potential complications. Regular imaging and check-ups help catch any issues early.
Hip replacement for these patients is more complex than for those with typical arthritis, but with careful planning, advanced technology, and specialized techniques, long-term success is achievable.
Why Choose Dr. Alexander McLawhorn?
Dr. Alexander McLawhorn is a highly experienced hip and knee replacement surgeon, performing over 600 joint replacements each year, including more than 400 robot-assisted anterior hip replacements. He specializes in minimally invasive techniques like the bikini incision, hip resurfacing, and rapid-recovery joint replacement. By using robotics and custom implants, he improves precision, recovery, and long-term joint function.
Dr. McLawhorn was trained at Columbia, Yale, and HSS, and now serves as the Director of Research and Innovation for the Adult Reconstruction and Joint Replacement Service at HSS. His expertise includes treating complex hip conditions, particularly joint replacements for adults with childhood hip disorders.
Frequently Asked Questions:
What Lifestyle Changes Help Protect a Hip Affected by a Childhood Disorder?
Maintaining a healthy weight reduces joint stress, while low-impact exercises like swimming and cycling help keep the hip strong. Stretching improves flexibility, and assistive devices can relieve pressure. Avoiding high-impact activities prevents further joint damage.
What Are the Risks of Delaying Hip Replacement?
Waiting too long can lead to worsening pain, stiffness, and mobility loss. Further joint deterioration may make surgery more complex and recovery more difficult. Severe cases may require more extensive reconstruction.
Are There Non-Surgical Treatments for Degenerative Hip Disease?
Yes, options include physical therapy, anti-inflammatory medications, joint injections, and lifestyle changes like weight management. These can help manage pain but won’t reverse joint damage.
Does Insurance Cover Hip Replacement for Adults with Childhood Hip Disorders?
Most insurance plans, including Medicare, cover hip replacement if it’s medically necessary. Coverage varies, so check with your provider about pre-authorization, costs, and in-network surgeons.
Contact Alexander McLawhorn
If you had a childhood hip disorder and need treatment as an adult, contact Dr. Alexander McLawhorn, a hip and knee surgeon in New York City and Stamford, CT, for a consultation.
Call either of our locations to get started:Â
