Osteoarthritis of the young adult hip: etiology and treatment.

Childhood hip disorders contribute to a significant proportion of young adults with painful osteoarthritis of the hip. Prosthetic hip replacement rarely is indicated for active young adults with osteoarthritis of the hip because of high failure rates without subsequent solutions. Modern osteotomies provide a viable alternative for these individuals. Recently published data indicate that the osteotomy can have reliable results with more modest expectations. Four requirements must be met. The orthopaedist should grasp the modern principles of osteotomy and be willing to carry out more involved operative planning. The patient should exhibit a mature understanding of alternatives and long-range goals of treatment. Both orthopaedist and patient should commit themselves to a long-term relationship, beyond the 6-month rehabilitation period. The patient should be willing to compromise some motion (hip mobility) for pain relief and increased function.