So I had my appointment on Tuesday at clinic, I had managed to get one a couple of months earlier than originally planned, which I'm very relieved about as my left hip is making me anxious. We had a long discussion about my options for this hip.
Option 1 is do nothing. My right hip will get stronger and start to compensate for the left. The left will eventually become arthritic and need a THR, and from his guess (and my own) it won't make it to 50. Tricky for him to give me a more accurate age though as he says a lot of figures about THRs are taken from the 80s and 90s when it near impossible to get a THR before 50 - you had to be really crippled with OA to push to get one. It seems like it doesn't have to be quite as bad now. But waiting until the joint becomes arthritic (and in the meantime becoming more painful and de-conditioned) does not sound fun.
Option 2 is the redo - a left TPO, which has the same risks as a normal TPO (nerve damage, malposition, non-union, bone damage, DVT, PE...) except there are higher risks of blood loss and nerve damage, due to the fact that there will be scarring, so things like muscle tissue will be tethered down a bit more than normal so harder to move out of the way. There is also a higher risk of malposition (not getting the fragment of the hip socket into the right position) because it will be harder to move due to the scarring and tethered tissue. So overall there is a higher risk that there won't be such a good outcome in the left hip after surgery.
Option 3 was me tentatively asking about a replacement now instead. However this is not the right option at all, as there is no OA in the joint yet, and anyway, there needs to be enough bone to work with to put a replacement in. And, of course, the earlier I have a THR, the more revisions I would need.
So I chose option 2, because even with the risks involved, doing nothing carries with it a greater risk of long term pain and mobility issues. My consultant was very realistic about what he was and wasn't able to do with a 'redo' operation, and he was very clear about everything when I discussed the options with him. Even though it's a really tough decision to make, I feel clear about so much more of all this. I feel in control of what I am deciding about my own health condition, because I've been given time to discuss it and ask all my questions and get them ALL answered clearly.
I mean there is choice, but there is no choice, all the same. I don't get to choose whether or not I have hip dysplasia, but I feel more in control of what I am choosing now, and in a weird way I feel a bit better about it.
