Fusion or osteotomy???

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I have a 12 yr old son who had a slipped capital femoral epiphysis. A pin was put in and all seamed fine. Approx 6 mos later and after complaining about pain an x-ray indicated that avascular necrosis developed. Surgery was performed and the screw removed. This lessened the pain, but only slightly. After waiting another 6 mos to see if the head might regenerate itself, subsequent x-rays showed no improvement. The doctor has proposed the posibility of either osteotomy or fusion. He is confering with his coleages and will be getting back to us in about a month with, I suppose, his recommendations. I could use some help with preparing the right questions to ask and well as some background on pros and cons.

-- Joseph Goulet (jgoulet777@aol.com), February 02, 2003


Hi joseph For the last two years I dedicated myself strongly advising against hip fusion. My own experience with a fused right hip which gave me a poor life style from the age of 25 until I was 70 is more than enough to advise you not to go along with the fusion option.With a fused hip you will eventualy damage your knee below the fuswed hip.You will develop back pain. You will lose the ability to stand straight,drive unless automatic gear changher,put on your shoes and socks without bending your knee and rotating it sideway which gradually but surely causes knee replacement and other many day to day discomfort and pain.Take another opinion but I think you ought to choose osteotomy which may allow for a THR when your son is old enough. By the way I had my hip defused at the age of 71. I had to. My email is rosha2000@yahoo.com Roushdy

-- Roushdy Abouseda (rosha2000@yahoo.com), February 15, 2003.

Both are reasonable options. The osteotomy may be more versatile. If for some reason it failed he could still have a fusion at a later date.

-- Timothy S. Johnson, M.D. (tjohns55@jhmi.edu), April 23, 2003.

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