Hip Salvage

Treatment options for end-stage arthritis

Normal hip function cannot be restored once end stage arthritis destroys the articular cartilage. Treatment is predominantly for pain relief, which can be produced by various salvage procedures.

Procedure Description Disadvantages
Total Hip Arthroplasty Most commonly performed with very good results — native femoral head and acetabulum replaced by metallic implants Not preferred in young people due to concerns of wear and loosening requiring repeated surgery — repeated surgery tends to be less successful
Hip Arthrodesis Femoral head fused to the acetabulum — provides excellent pain relief and is durable Difficulty with certain activities, spine and knee arthritis in the long term — conversion to a total hip is difficult and less successful
Hip Distraction Long pins placed through the skin into the pelvis and femur, hip joint pulled apart to allow cartilage growth — minimally invasive and adjustable Pins frequently get infected and loosen — uncommonly used and is not likely to work
Growth Hormone Injection Injection of high doses of growth hormone into the joint was shown to produce cartilage in a few patients Not an approved treatment — dosage is experimental
Pelvic Support Osteotomy Femoral bone cut and bent outwards to support the pelvis and eliminate limp — a second cut close to the knee allows realignment — can allow good painless motion without a limp or apparent deformity Requires longer period for lengthening the limb with several complications — creates major internal deformity of the bone — makes conversion to a total hip very difficult