ceramic hip, graft, or nothing at all

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I have necrosis in might right femoral head, it started in 1980 after I broke the femoral neck - was on crutches for 3 years till I had the plate and screws out, hoped it would re-hematize, but it didn't. Did get off the crutches tho and can walk, run, and practice my favorite hobby, restoring old RR equipment (read: lots of lifting/carrying of pretty heavy stuff). I'm 44, in pretty good health otherwise, and not in alot of pain right now, though the xrays look ugly (picture an orange that got left in the fridge for a few months - smaller and lumpier) Orig. doc said to wait as long as possible. Good advice. Questions, I thought the ceramic hip was already out, and would be a good option for someone like me who plays hard. Am I mistaken? Would a graft be better? I saw an orthopedist a couple years ago, after looking at the xrays, he told me to just call him when I was ready and he'd meet me at the hospital, no need to go back to his office. What I DO NOT want is to do this more than one. The food is TERRIBLE!

-- rudd long (rudd@cogdellmendrala.com), February 11, 2003


Judging from your descriptions of your x-rays it does not sound like anything other than a total hip replacement would help, so therefore the graft is out. Total hip replacement is a very successful procedure for those who need it, by need it I mean either their pain or their activity has worsened to the point where it becomes intolerable. Since you are still very active and your pain is tolerable, I would advise against having any sort of surgery unless you are loosing bone stock and this can be determined by x-ray examination.

As far as ceramic versus conventional metal on polyethylene, the jury is still out. The ceramic wears better in the lab. It does have a problem with fracturing under certain circumstances however. I hope this helps.

-- Marc W. Hungerford, M.D. (mhunger@jhmi.edu), March 27, 2003.

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