Hi all -

I'm wondering if anyone here can offer insight/ideas related to hip pain.

My left hip is moderately arthritic, subluxed, and only extends to about 150
degrees due to a contracture. It pops in and out of the socket when my tone
is generally high, when I spasm, and often during my pivot transfers and
other weight bearing . It hurts significantly most of the time, except in
during the first 6-8 weeks following botox. We are trying to find ways to
work around the side effects I experience from the pump (I will be seen at
the UCSF Pain Management Clinic where they can add different meds to the
baclofen to end the parasthesia or central pain I've been experiencing).
Anyway, when the pump is delivering appropriate amounts of baclofen, it is
greatly helpful in reducing my tone and the hip pain that results from my
excess tone. I just got a very cool stander, which should help with the
contracture and my osteoporosis, but I'm somewhat concerned about how it
will my hip.

So, my current dilemma is whether to try to do something about the
subluxation and maybe the arthritis. I saw an orthopedic surgeon who talked
about different osteotomies we could do (dig out and reform the hip socket,
and break the head of the femur and angle it into the socket and pin it).
This would actually take care of both the subluxation and they would scrape
away the arthritic tissue, but this is a very painful surgery and involves 6
weeks in a body cast (chest to toes). They do this a lot with CP kids, which
I have mixed feelings about, but handling a child in a body cast has to be
easier than handling an adult in a body cast. This does not sound fun. A
variation on this option is to cut the femur off altogether.

Another option would be a total hip replacement where they would also pin
the ball into the socket. Current total hips last about 15 years and I'm 40,
so that would mean doing it again in my lifetime (assuming I live that
long). I'm concerned that my high tone and osteoporosis would decrease the
life span of the replacement, because eventually the artificial parts begin
to loosen from the bone.

A third option is just to live with it.

So, my questions:

Has anyone here had an osteotomy a how did it turn out? Joy, I think you had
the heads of your femurs removed, how is that going and do you have any
weight bearing ability? Has anyone here had, or considered, a hip
replacement and with what outcome? For anyone who is 'just living with it',
has it worsened with time?

Thanks for any input y'all can give me.

Pam