Current Trends in the Treatment of the Young Adult with Disabling Hip Disease

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Abstract
The otherwise physically fit young adult with unilateral disabling hip disease poses a treatment dilemma for the orthopedic surgeon. In an effort to gain some insight into current treatment trends for this group ten eminent hip surgeons were each sent case histories and pertinent X-rays of two otherwise fit young adults with disabling unilateral hip disease. Their treatment suggestions are analyzed following a review of the possible alternatives. Two features of the survey stood out: 1) For both patients a significant number of respondents favored total hip replacement; 2) John Charnley, who has been at the forefront in the development of total hip arthroplasty recommended that both patients wait until the total hip problems of component loosening and excessive wear are solved, (he predicts these solutions will come within the next five years) and then undergo total replacement. Ironically then, at a time when there may be a trend toward performing total hip replacement in otherwise fit young people with disabling hip disease, one of the prime developers of total hip replacement is calling for a moratorium on this course of action until the problems of total hip pertinent to young people are solved.

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