Document Detail


Function and fixation of total hip arthroplasty in patients 25 years of age or younger.
MedLine Citation:
PMID:  20668972     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
John C Clohisy; Jeremy M Oryhon; Thorsten M Seyler; Christopher W Wells; Steve S Liu; John J Callaghan; Michael A Mont
Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Clinical orthopaedics and related research     Volume:  468     ISSN:  1528-1132     ISO Abbreviation:  Clin. Orthop. Relat. Res.     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-11-08     Completed Date:  2010-12-06     Revised Date:  2013-05-29    
Medline Journal Info:
Nlm Unique ID:  0075674     Medline TA:  Clin Orthop Relat Res     Country:  United States    
Other Details:
Languages:  eng     Pagination:  3207-13     Citation Subset:  AIM; IM    
Affiliation:
Department of Orthopaedic Surgery, Washington University School of Medicine, St Louis, MO 63110, USA. clohisyj@wudosis.wustl.edu
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Age Factors
Arthroplasty, Replacement, Hip* / adverse effects
Child
Female
Hip Joint / physiopathology,  radiography,  surgery*
Humans
Male
Osteoarthritis, Hip / physiopathology,  radiography,  surgery*
Osteonecrosis / physiopathology,  radiography,  surgery*
Range of Motion, Articular
Retrospective Studies
Time Factors
Treatment Outcome
United States
Young Adult
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