Function and fixation of total hip arthroplasty in patients 25 years of age or younger.

Published

Conference Paper

BACKGROUND: The treatment of end-stage hip disease in very young patients is controversial, with advocates for nonoperative treatment, hip arthrodesis and replacement procedures. The functional improvements in this group of patients are not well documented and whether the condition for which the surgery is performed influences function. QUESTIONS/PURPOSES: We determined whether (1) modern THA provides major functional improvements; (2) disease-specific factors impact the magnitude of improvement; (3) these procedures are associated with early failures and complications; and (4) radiographically secure implant fixation is achieved with contemporary implants. METHODS: We retrospectively reviewed 88 patients (102 hips) who had THA and were 25 years or younger at surgery. The most common diagnoses were osteonecrosis (44%) and secondary osteoarthritis (41%). All patients received a cementless socket of varying designs and all except five a cementless stem. Demographic data, Harris hip score, and Charnley classification were recorded. Radiographic evaluation was used to determine implant fixation. We identified complications and failure mechanisms. The minimum followup was 2 years (median, 4.2 years; range, 2-16 years). RESULTS: The 95 nonrevised hips were followed clinically an average of 61 months. The mean Harris hip scores improved from 42 preoperatively to 83 postoperatively. Lower Harris hip scores were associated with systemic disease (Charnley Class C). Seven hips (7%) underwent revision. There were nine (9%) major complications. One hundred percent of femoral stems and 98% of acetabular components were well-fixed at last followup. CONCLUSION: Contemporary total hip arthroplasty in patients 25 years of age and younger is associated with improved hip function, and secure fixation of cementless implants at early followup.

Full Text

Duke Authors

Cited Authors

  • Clohisy, JC; Oryhon, JM; Seyler, TM; Wells, CW; Liu, SS; Callaghan, JJ; Mont, MA

Published Date

  • December 2010

Published In

Volume / Issue

  • 468 / 12

Start / End Page

  • 3207 - 3213

PubMed ID

  • 20668972

Pubmed Central ID

  • 20668972

Electronic International Standard Serial Number (EISSN)

  • 1528-1132

International Standard Serial Number (ISSN)

  • 0009-921X

Digital Object Identifier (DOI)

  • 10.1007/s11999-010-1468-4