Long-term follow-up of 96 patients younger than age 25 with 119 primary cemented total hip arthroplasties
DOI:
https://doi.org/10.2340/17453674.2023.9410Keywords:
Arthroplasty, Hip, Implants, Total hip arthroplasty, Very young patientsAbstract
Background and purpose: Long-term follow-up of young patients following cemented primary THA is scarce. Therefore, we analyzed the survival of all consecutive primary THAs in patients under 25 years performed at our institute.
Patients and methods: All primary THAs performed in patients younger than 25 years in our tertiary care institute between 1988 and 2015 were included (n = 119). Cemented fixation was used in all patients. In the case of acetabular bone deficiencies, reconstruction was performed using impaction bone grafting (IBG). We used Kaplan–Meier analysis to determine the survival of the primary THA with endpoints revision for any reason and aseptic loosening.
Results: The mean age at the primary THA was 20 years. The most prevalent diagnosis was avascular necrosis (31%). The mean follow-up of the primary THA was 11 years (range 0–32). 2 patients (2 hips) were lost to follow-up. 16 revisions were registered. The survival of any component for endpoint revision for any reason was estimated at 92% (95% confidence interval [CI] 84–96) and 81% (CI 67–90) at 10- and 15-year follow-up, respectively. The survival of any component for endpoint revision for aseptic loosening was 99% (CI 93–100) and 88% (CI 71–95) at 10 and 15 years, respectively. 3 hips were revised due to infection.
Conclusion: Favorable long-term outcomes of primary THA in very young patients can be obtained using cemented fixation and IBG.
Downloads
References
Wroblewski B M, Purbach B, Siney P D, Fleming P A. Charnley low-friction arthroplasty in teenage patients: the ultimate challenge. J Bone Joint Surg Br 2010; 92(4): 486-8. DOI: https://doi.org/10.1302/0301-620X.92B4.23477
Witt J D, Swann M, Ansell B M. Total hip replacement for juvenile chronic arthritis. J Bone Joint Surg Br 1991; 73(5): 770-3. DOI: https://doi.org/10.1302/0301-620X.73B5.1894663
Torchia M E, Klassen R A, Bianco A J. 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. DOI: https://doi.org/10.2106/00004623-199607000-00003
Sedrakyan A, Romero L, Graves S, Davidson D, de Steiger R, Lewis P, et al. Survivorship of hip and knee implants in pediatric and young adult populations: analysis of registry and published data. J Bone Joint Surg Am 2014; 96(Suppl. 1): 73-8. DOI: https://doi.org/10.2106/JBJS.N.00541
Ruddlesdin C, Ansell B M, Arden G P, Swann M. Total hip replacement in children with juvenile chronic arthritis. J Bone Joint Surg Br 1986; 68(2): 218-22. DOI: https://doi.org/10.1302/0301-620X.68B2.3958006
Metcalfe D, Peterson N, Wilkinson J M, Perry D C. Temporal trends and survivorship of total hip arthroplasty in very young patients: a study using the National Joint Registry data set. Bone Joint J 2018; 100-B(10): 1320-9. DOI: https://doi.org/10.1302/0301-620X.100B10.BJJ-2017-1441.R2
Kamath A F, Sheth N P, Hosalkar H H, Babatunde O M, Lee G C, Nelson C L. Modern total hip arthroplasty in patients younger than 21 years. J Arthroplasty 2012; 27(3): 402-8. DOI: https://doi.org/10.1016/j.arth.2011.04.042
Tsukanaka M, Halvorsen V, Nordsletten L, Engesaeter I O, Engesaeter L B, Fenstad A M, et al. Implant survival and radiographic outcome of total hip replacement in patients less than 20 years old. Acta Orthop 2016; 87(5): 479-84. DOI: https://doi.org/10.1080/17453674.2016.1212180
Halvorsen V, Fenstad A M, Engesæter L B, Nordsletten L, Overgaard S, Pedersen A B, et al. Outcome of 881 total hip arthroplasties in 747 patients 21 years or younger: data from the Nordic Arthroplasty Register Association (NARA) 1995–2016. Acta Orthop 2019; 90(4): 331-7. DOI: https://doi.org/10.1080/17453674.2019.1615263
Hannouche D, Devriese F, Delambre J, Zadegan F, Tourabaly I, Sedel L, et al. Ceramic-on-ceramic THA implants in patients younger than 20 years. Clin Orthop Relat Res 2016; 474(2): 520-7. DOI: https://doi.org/10.1007/s11999-015-4546-9
Finkbone P R, Severson E P, Cabanela M E, Trousdale R T. Ceramic-on-ceramic total hip arthroplasty in patients younger than 20 years. J Arthroplasty 2012; 27(2): 213-19. DOI: https://doi.org/10.1016/j.arth.2011.05.022
D’Ambrosi R, Marciandi L, Frediani P V, Facchini R M. Uncemented total hip arthroplasty in patients younger than 20 years. J Orthop Sci 2016; 21(4): 500-6. DOI: https://doi.org/10.1016/j.jos.2016.03.009
Clohisy J C, Oryhon J M, Seyler T M, Wells C W, Liu S S, Callaghan J J, 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. DOI: https://doi.org/10.1007/s11999-010-1468-4
Restrepo C, Lettich T, Roberts N, Parvizi J, Hozack W J. Uncemented total hip arthroplasty in patients less than twenty-years. Acta Orthop Belg 2008; 74(5): 615-22.
Ledford C K, Vap A R, Bolognesi M P, Wellman S S. Total hip arthroplasty in very young bone marrow transplant patients. J Surg Orthop Adv 2015; 24(2): 99-104. DOI: https://doi.org/10.3113/JSOA.2015.0099
Schreurs B W, Slooff T J J H, Gardeniers J W M, Buma P. Acetabular reconstruction with bone impaction grafting and a cemented cup: 20 years’ experience. Clin Orthop Relat Res 2001; (393): 202-15. DOI: https://doi.org/10.1097/00003086-200112000-00023
DeLee J G, Charnley J. Radiological demarcation of cemented sockets in total hip replacement. Clin Orthop Relat Res 1976; (121): 20-32. DOI: https://doi.org/10.1097/00003086-197611000-00003
Gruen T A, McNeice G M, Amstutz H C. “Modes of failure” of cemented stem-type femoral components: a radiographic analysis of loosening. Clin Orthop Relat Res 1979; (141): 17-27. DOI: https://doi.org/10.1097/00003086-197906000-00002
Harris W H, McCarthy J C J, O’Neill D A. Femoral component loosening using contemporary techniques of femoral cement fixation. J Bone Joint Surg Am 1982; 64(7): 1063-7. DOI: https://doi.org/10.2106/00004623-198264070-00017
Brooker A F, Bowerman J W, Robinson R A, Riley L H J. Ectopic ossification following total hip replacement: incidence and a method of classification. J Bone Joint Surg Am 1973; 55(8): 1629-32. DOI: https://doi.org/10.2106/00004623-197355080-00006
Learmonth I D, Heywood A W, Kaye J, Dall D. Radiological loosening after cemented hip replacement for juvenile chronic arthritis. J Bone Joint Surg Br 1989; 71(2): 209-12. DOI: https://doi.org/10.1302/0301-620X.71B2.2925736
Bryant D, Havey T C, Roberts R, Guyatt G. How many patients? how many limbs? Analysis of patients or limbs in the orthopaedic literature: a systematic review. J Bone Joint Surg Am 2006; 88(1): 41-5. DOI: https://doi.org/10.2106/00004623-200601000-00006
Additional Files
Published
How to Cite
License
Copyright (c) 2023 Erim Özdemir, Martijn F L Kuijpers, B Willem Schreurs, Wim H C Rijnen
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
