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Hip Replacement (Total Hip Arthroplasty) in Teens and Young Adults

Hip Replacement (Total Hip Arthroplasty) in Teens and Young Adults

Reviewed by Christopher J. DeFrancesco, MD

Reviewed on

What is hip replacement (total hip arthroplasty)?

A total hip arthroplasty – also called hip replacement – is a surgery that replaces a damaged hip joint with an artificial implant. The hip is a ball-and-socket joint made up of the ball (femoral head) of the thigh bone (femur) and the hip socket (acetabulum). In total hip replacement, both the ball and socket are replaced with an artificial implant to improve movement and relieve pain.

When is hip replacement recommended for teens and young adults?

Hip replacement is considered only after nonsurgical treatments have failed and when hip-preservation procedures are not a good option (like when the ball part of the socket is no longer round or the cartilage lining of the joint has worn away). For many young patients, treatment may begin with physical therapy, medications, or injections. 

In cases where hip preservation is reasonable, we may offer special surgeries – like periacetabular osteotomy or hip arthroscopy – which are designed to preserve the natural hip joint. 

However, when hip preservation is no longer an option and symptoms are making daily activities difficult, total hip replacement may become the best choice for restoring mobility and quality of life.

Conditions that can lead to end-stage hip damage in young people

While many different conditions can lead to a total hip replacement, the most common causes in young patients include: 

How doctors determine if surgery is needed

Total hip replacement in teens and young adults is uncommon, but sometimes it is the best option. At Children’s Hospital of Philadelphia (CHOP), orthopedic surgeons with special training in hip disorders evaluate patients, review all prior treatments and determine if total hip replacement is the best treatment for this individual patient. 

Along with the conditions listed above, clinicians will assess whether:

  • Developmental misalignment or structural abnormalities are causing early wear of the hip joint
  • How future growth may affect any hip replacement
  • Genetics, injuries and/or obesity play a contributing role 

Why is hip replacement less common in children and teens?

Hip replacement has historically been avoided in younger patients because many are still growing and may eventually need revision surgery later in life. However, advances in surgical techniques and implant materials have improved long-term outcomes for adolescents and young adults.

How long does a hip replacement last for young patients?

Modern hip implants last longer than older generations of implants. Many people ask about the expected lifespan of a modern hip implant. Research now shows that most function well for 20 or more years when put into adults.

Because younger patients are more active, the expected lifespan for similar implants in younger people may be lower, and we cannot perfectly predict how long they will last. But advances in implants and materials provide hope for longevity more than 15 years (and hopefully more). Of course, that means almost any young person undergoing a hip replacement will need at least one revision surgery later in adulthood.

Benefits of the newer hip implants

  • Longer-term durability and minimal wear rates
  • Enhanced stability and material strength

What are the benefits of hip replacement in young patients?

Many teens and young adults experience significant improvements after hip replacement surgery, including:

  • Reduced pain
  • Better mobility and function
  • Improved quality of life
  • Return to school, work, sports and daily activities

Studies also show strong patient-reported outcomes and high rates of satisfaction after hip replacement surgery.

What are the risks or downsides of hip replacement for younger patients?

Like all major surgeries, hip replacement carries risks. Possible complications include infection, instability, implant loosening, fracture around the implant, or the need for future revision surgery.

Because younger patients place more demand on the joint over time, long-term follow-up care is important.

What are the alternatives to hip replacement for young patients?

Hip replacement is almost never the first treatment choice. Depending on the patient’s condition, alternatives may include:

Preparing for total hip replacement surgery

Before surgery, patients undergo imaging studies such as X-rays, CT scans, or MRI scans to help surgeons plan the procedure and select the best implant.

Patients may also meet with anesthesia, physical therapy and other specialists before surgery. Families receive detailed instructions about medications, eating and drinking restrictions, and recovery planning. Please follow all instructions from your surgical team carefully, or surgery may be rescheduled or cancelled.

What happens during hip replacement surgery, and how is it different for young patients?

During hip replacement surgery, damaged cartilage and bone are removed and replaced with prosthetic components. The day before surgery, patients and families will be instructed about what time to arrive at the hospital, what to bring, and what to expect during surgery and recovery. 

At a high level, here is what you can expect:

  • Your child will be undergo general anesthesia during the surgery. They may also get a nerve block to help manage pain after surgery.
  • Depending on your child’s anatomy, surgeons will make an incision on the side (posterior) or front (anterior) of the hip. The specific approach is tailored to the patient based on their size, flexibility, and history of prior surgeries. The incision is generally 4-8 inches long.
  • Once surgeons access the hip joint, they will remove the damaged bone and cartilage and replace them with prosthetic components. Modern implants commonly include metal, ceramic, and highly cross-linked polyethylene components designed for durability and smoother movement.
  • Once the hip replacement parts are in the correct position, surgeons use advanced techniques to minimize scarring including using fine, clear stitches that dissolve on their own, avoiding staples or cross-stitches whenever possible. 

What is recovery like after hip replacement for young patients?

Most patients stay in the hospital for 1-4 days after surgery and begin walking within 24 hours.

Physical therapists will evaluate the patient while they are in the hospital. Outpatient physical therapy will start within a few weeks of surgery. Most patients return to basic daily activities in the weeks following surgery, although full recovery may take 6-12 months. 

Returning to school, sports or work

Many young patients return to active lifestyles after hip replacement. Low-impact activities such as walking, swimming, cycling, and golf are encouraged. High-impact sports may be discouraged to help protect the implant over time. Specifically, contact sports (football, rugby, ice hockey, etc.) are not allowed.

Setting graduated milestones, such as walking or participating in low-impact sports, can help patients feel motivated during recovery after a hip replacement. The return to athletic pursuits varies from patient to patient. In some cases, younger patients may experience a more intense early recovery. 

What outcomes and long-term results can families expect after hip replacement?

Today’s hip replacements provide better durability, function, and pain relief than earlier generations of implants. Most patients experience long-term improvements in mobility and quality of life.
 
Because younger patients are likely to outlive their implant, revision surgery may eventually be needed later in adulthood. In general, we expect successful hip replacements to last more than 20 years, although this number may be lower in young active people. Young patients who are obese or take part in high impact sports may at greater risk of needing hip revision surgery sooner than others.

What questions should families ask before total hip replacement surgery?

When families are considering whether hip replacement surgery is right for their child, teen or young adult, they should seek answers from pediatric orthopedic experts – who understand growing bones and how they affect the patient’s development, functionality and typical use. 

Some questions to consider:

  • What type of implant is best for the patient?
  • How many revision surgeries will they need over their lifetime?
  • How long is recovery expected to take?
  • When can normal activities or sports resume?
  • What restrictions will exist after surgery? (Both short and long term.)
  • What are the risks and long-term expectations?

Why choose CHOP for hip replacement in young patients?

CHOP’s Young Adult Hip Preservation Program is designed to meet the needs of older teens and young adults with hip disorders caused by underlying pediatric conditions. Our dedicated program offers:

  • Expertise. As a leading regional program for adolescents and young adults with hip pain, our surgeons perform complex orthopedic procedures with a focus on hip preservation and restoring function. When non-surgical and preservation options are no longer effective, we offer total hip replacement.
  • A focus on improving care. Our specialists are engaged in active research focused on better understanding hip disorders and refining surgical techniques, implant options and imaging. This helps us to improve long-term outcomes for young patients.
  • Comprehensive care. We provide full-spectrum, family-centered care from evaluation through long-term follow-up, with individualized treatment plans and age-appropriate support at every stage.

Read more about what sets us apart. We’re here to answer any questions you have.

Why more young adults are receiving hip replacements

Hip replacements in young adults are increasing as treatment decisions shift away from age-based delays and toward function, pain control and quality of life.

Today, surgery is considered when symptoms significantly limit daily life – even  in younger patients. Care also focuses on long-term planning since revision surgery may be needed later in life.

Frequently asked questions about hip replacement in teens

Can teenagers get hip replacements?

Yes. Although uncommon, hip replacement may be recommended when severe pain and joint damage limit function and other treatments no longer help.

Is hip replacement safe for teenagers/young patients?

Yes. Total hip replacement is considered safe and highly effective.

Will my child need another hip replacement later in life? 

Most likely, yes. Modern implants often last 20+ years (in adult studies), but younger patients will very likely need revision surgeries.

Can you play sports after hip replacement?

Yes, many patients return to low-impact sports and physical activity after recovery. Low-impact activities like walking, swimming, golfing and cycling are recommended. Contact sports are not allowed.

Will there be a scar?

Yes. Surgery requires an incision, generally 4-8 inches long, which will leave a scar. Our surgeons use techniques designed to minimize scarring. Beyond a scar on their hip, their outward appearance will not change appreciably.
Christopher J. DeFrancesco, MD

Surgeon spotlight

Orthopedic surgeon Christopher J. DeFrancesco, MD, recently returned to CHOP. Here, he explains why he chose to specialize in pediatric hip care, his approach to hip preservation and how he cares for children and teens facing the prospect of hip surgery or hip replacement.