Long Term Outcomes of Total Hip Arthroplasty in Young Patients under 30

Document Type: RESEARCH PAPER

Authors

1 Emilios E. Pakos Lecturer in Orthopaedics and Biomechanics Orthopaedic Surgeon Laboratory of Orthopaedics and Biomechanics School of Medicine University of Ioannina Greece

2 Orthopaedic Surgeon Laboratory of Orthopaedics and biomechanics School of Medicine University of Ioannina Greece

3 Professor in Orthopaedics Laboratory of Orthopaedics and Biomechanics School of Medicine University of Ioannina Greece

Abstract

Background:
 We aimed to report outcomes of total hip arthroplasty (THA) in very young patients under the year of 30.  
Methods:
 Thirty patients (45 hips) with various indications for THA were retrospectively reviewed radiologically and clinically and analyzed regarding survival, reasons of failure, factors associated with outcomes and postoperative complications.  
Results:
 Within a mean follow-up time of 116 months the 10-year survival rate was 90.3%. All hips were revised due to aseptic loosening. No association was found among the tested parameters with increased revision rates.Three complications associated with the THA were recorded and managed conservatively. All patients had statistically significant improved clinical scores compared to the pre-operative period, despite the underlying disorder that compromised the condition in the majority of the patients.
Conclusions:
 Our study showed excellent long term outcomes of THA in patients younger than 30 years of age, comparable with those in older patients.

Keywords


Springer BD, Connelly SE, Odum SM, Fehring TK, Griffin WL, Mason JB, et al. Cementless femoral components in young patients: review and meta-analysis of total hip arthroplasty and hip resurfacing. J Arthroplasty. 2009; 24(6): 2–8.

  • Torchia ME, Klassen RA, Bianco AJ. Total hip arthroplasty with cement in patients less than twenty years old. Long-term results. J Bone Joint Surg Am. 1996; 78(7):995-1003.

  • Finkbone PR, Severson EP, Cabanela ME, Trousdale RT. Ceramic-on-ceramic total hip arthroplasty in patients younger than 20 years. J Arthroplasty. 2012; 27(2): 213–9.

  • Wangen H, Lereim P, Holm I, Gunderson R, Reikeras O. Hip arthroplasty in patients younger than 30 years: excellent ten to 16-year follow-up results with a HA-coated stem. Int Orthop. 2008; 32(2): 203–8.

  • Busch V, Klarenbeek R, Slooff T, Schreurs BW, Gardeniers J. Cemented hip designs are a reasonable option in young patients. Clin Orthop Relat Res. 2010; 468(12): 3214-20.

  • Engesæter LB, Engesæter IØ, Fenstad AM, Havelin LI, Kärrholm J, Garellick G, et al. Low revision rate after total hip arthroplasty in patients with pediatric hip diseases. Acta Orthop. 2012; 83(5): 436-41.

  • Chmell MJ, Scott RD, Thomas WH, Sledge CB. Total hip arthroplasty with cement for juvenile rheumatoid arthritis. Results at a minimum of ten years in patients less than thirty years old. J Bone Joint Surg Am. 1997; 79(1): 44-52.

  • Haber D, Goodman SB. Total hip arthroplasty in juvenile chronic arthritis: a consecutive series. J Arthroplasty. 1998; 13(3): 259–65.

  • Adelani MA, Keeney JA, Palisch A, Fowler SA, Clohisy JC. Has total hip arthroplasty in patients 30 years or younger improved? A systematic review. Clin Orthop Relat Res. 2013; 471(8): 2595-601.

  • Clohisy JC, Oryhon JM, Seyler TM, Wells CW, Liu SS, Callaghan JJ, et al. Function and fixation of total hip arthroplasty in patients 25 years of age or younger. Clin Orthop Relat Res. 2010; 468(12): 3207–13.

  • Learmonth ID, Heywood AW, Kaye J, Dall D.  Radiological loosening after cemented hip replacement for juvenile chronic arthritis. J Bone Joint Surg Br. 1989;71(2): 209–12.

  • D’ Aubigne RM, Postel M. Functional results of hip arthroplasty with acrylic prosthesis. J Bone Joint Surg Am. 1954; 36(3): 451-75.

  • Brooker AF, Bowerman JW, Robinson RA, Riley LH Jr. Ectopic ossification following total hip replacement. Incidence and a method of classification. J Bone Joint Surg Am. 1973; 55(8): 1629-32.

  • Kaplan EL, Meier P. Nonparametric estimation from incomplete observations. J Am Stat Assoc. 1958; 53(282): 457-81.

  • Hwang KT, Kim YH, Kim YS, Choi IY. Total hip arthroplasty using cementless grit-blasted femoral component: a minimum 10-year follow-up study. J Arthroplasty. 2012; 27(8): 1554-61.

  • Lazarinis S, Kärrholm J, Hailer NP. Effects of hydroxyapatite coating on survival of an uncemented femoral stem. A Swedish Hip Arthroplasty Register study on 4,772 hips. Acta Orthop. 2011; 82(4): 399-404.

  • Lee JM, Nam HT. Acetabular revision total hip arthroplasty using an impacted morselized allograft and a cementless cup: minimum 10-year follow-up. J Arthroplasty. 2011; 26(7): 1057-60.

  • Ali MS, Kumar A. Hydroxyapatite-coated RM cup in primary hip arthroplasty. Int Orthop. 2003; 27(2): 90-3.

  • Müller LA, Wenger N, Schramm M, Hohmann D, Forst R, Carl HD.  Seventeen-year survival of the cementless CLS Spotorno stem. Arch Orthop Trauma Surg. 2010; 130(2): 269-75.

  • Scott RD, Sarokhan AJ, Dalziel R. Total hip and total knee arthroplasty in juvenile rheumatoid arthritis. Clin Orthop Relat Res. 1984; 182: 90-8.

  • Bilsel N, Gökçe A, Kesmezacar H, Mumcuoğlu E, Ozdoğan H. Long-term results of total hip arthroplasty in patients with juvenile rheumatoid arthritis. Acta Orthop Traumatol Turc. 2008; 42(2): 119-24.

  • Cruz-Pardos A, García-Rey E, García-Cimbrelo E, Ortega-Chamarro J. Alumina-on-alumina THA in patients with juvenile idiopathic arthritis: a 5-year follow up study. Clin Orthop Relat Res. 2012; 470(5): 1421-30.

  • De Ranieri A, Wagner N, Imrie SN, Hwang KL, Goodman SB. Outcome of primary total hip arthroplasty in Charnley Class C patients with juvenile idiopathic arthritis: a case series. J Arthroplasty. 2011; 26(8): 1182-8.

  • Kitsoulis PB, Siamopoulou A, Beris AE, Xenakis TA. Total hip and knee arthroplasty for juvenile rheumatoid arthritis. Folia Med (Plovdiv). 2006; 48(3-4): 42-9.

  • Hekmat K, Jacobsson L, Nilsson JÅ, Petersson IF, Robertsson O, Garellick G, et al. Decrease in the incidence of total hip arthroplasties in patients with rheumatoid arthritis--results from a well defined population in south Sweden. Arthritis Res Ther. 2011; 13(2): 67.

  • Schoof B, Citak M, O’Loughlin PF, Kendoff D, Haasper C, Gehrke T, et al. Eleven year results of total hip arthroplasty in patients with secondary osteoarthritis due to slipped capital femoral epiphysis. Open Orthop J. 2013; 7: 158-62.

  • Odent T, Journeau P, Prieur AM, Touzet P, Pouliquen JC, Glorion C. Cementless hip arthroplasty in juvenile idiopathic arthritis. J Pediatr Orthop. 2005; 25(4): 465-70.

  • Hyder N, Nevelos AB, Barabas TG. Cementless ceramic hip arthroplasties in patients less than 30 years old. J Arthroplasty. 1996; 11(6): 679-86.

  • Kamath AF, Sheth NP, Hosalkar HH, Babatunde OM, Lee GC, Nelson CL. Modern total hip arthroplasty in patients younger than 21 years. J Arthroplasty. 2012; 27(3): 402-8.

  • Girard J, Glorion C, Bonnomet F, Fron D, Migaud H. Risk factors for revision of hip arthroplasties in patients younger than 30 years. Clin Orthop Relat Res. 2011; 469(4): 1141-7.