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Total hip arthroplasty in patients with Down’s syndrome

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Abstract

Patients with Down’s syndrome (DS) have an increased incidence of coxarthrosis which may become symptomatic with prolonged life expectancy. We present seven consecutive patients (nine hips) with DS who had primary total hip arthroplasty (THA). Average clinical and radiological follow-up was 9.9 ± 6.4 years (range 2–22.25). Harris hip scores (HHS) improved significantly (p < 0.01) from 41.1 (range 18.5–65) to 80.2 (range 67.5–91) at latest follow-up. Two patients required revision arthroplasty for stem loosening at 16 (osteolysis) and six years (trauma) following THA, respectively. Six of the THAs required a constrained liner. No dislocations or deep infections were encountered. We contend that THA is a reliable surgical intervention in patients with DS and may be performed in symptomatic patients.

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References

  1. Stoll C, Alembik Y, Dott B, Roth MP (1998) Study of Down syndrome in 238,942 consecutive births. Ann Genet 41:44–51

    PubMed  CAS  Google Scholar 

  2. Kriss VM (1999) Down syndrome: imaging of multiorgan involvement. Clin Pediatr 38:441–449

    Article  CAS  Google Scholar 

  3. Nance WE, Engel E (1967) Human cytogenetics: a brief review and presentation of new findings. J Bone Joint Surg Am 49:1436–1454

    PubMed  CAS  Google Scholar 

  4. Shaw ED, Beals RK (1992) The hip joint in Down's syndrome. A study of its structure and associated disease. A study of its structure and associated disease. Clin Orthop Relat Res 278:101–107

    PubMed  Google Scholar 

  5. Penrose LS (1949) The incidence of mongolism in the general population. J Ment Sci 95:685–688

    PubMed  CAS  Google Scholar 

  6. Bittles AH, Glasson EJ (2004) Clinical, social, and ethical implications of changing life expectancy in Down syndrome. Dev Med Child Neurol 46:282–286

    Article  PubMed  CAS  Google Scholar 

  7. Friedman JM (2001) Radical disparities in median age at death of persons with Down syndrome. United States, 1968–1997. MMWR Morb Mortal Wkly Rep 50:463–465

    Google Scholar 

  8. Glasson EJ, Sullivan SG, Hussain R, Petterson BA, Montgomery PD, Bittles AH (2002) The changing survival profile of people with Down's syndrome: implications for genetic counselling. Clin Genet 62:390–393

    Article  PubMed  CAS  Google Scholar 

  9. Glasson EJ, Sullivan SG, Hussain R, Petterson BA, Montgomery PD, Bittles AH (2003) Comparative survival advantage of males with Down syndrome. Am J Hum Biol 15:192–195

    Article  PubMed  CAS  Google Scholar 

  10. Janicki MP, Dalton AJ, Henderson CM, Davidson PW (1999) Mortality and morbidity among older adults with intellectual disability: health services considerations. Disabil Rehabil 21:284–294

    Article  PubMed  CAS  Google Scholar 

  11. Kioschos M, Shaw ED, Beals RK (1999) Total hip arthroplasty in patients with Down's syndrome. J Bone Joint Surg Br 81:436–439

    Article  PubMed  CAS  Google Scholar 

  12. Skoff HD, Keggi K (1987) Total hip replacement in Down's syndrome. Orthopedics 10:485–489

    PubMed  CAS  Google Scholar 

  13. Hartofilakidis G, Stamos K, Karachalios T, Ioannidis TT, Zacharakis N (1996) Congenital hip disease in adults. Classification of acetabular deficiencies and operative treatment with acetabuloplasty combined with total hip arthroplasty. J Bone Joint Surg Am 78:683–692

    PubMed  CAS  Google Scholar 

  14. Massin P, Schmidt L, Engh CA (1989) Evaluation of cementless acetabular component migration. An experimental study. J Arthroplasty 4:245–251

    Article  PubMed  CAS  Google Scholar 

  15. DeLee JG, Charnley J (1976) Radiological demarcation of cemented sockets in total hip replacement. Clin Orthop Relat Res 121:20–32

    PubMed  Google Scholar 

  16. Kim YH (2008) The results of a proximally-coated cementless femoral component in total hip replacement: a five- to 12-year follow-up. J Bone Joint Surg Br 90:299–305

    PubMed  Google Scholar 

  17. Engh CA Jr, Culpepper WJ, Engh CA (1997) Long-term results of use of the anatomic medullary locking prosthesis in total hip arthroplasty. J Bone Joint Surg Am 79:177–184

    Article  PubMed  Google Scholar 

  18. Kim YH, Kim JS, Oh SH, Kim JM (2003) Comparison of porous-coated titanium femoral stems with and without hydroxyapatite coating. J Bone Joint Surg Am 85:1682–1688

    Article  PubMed  Google Scholar 

  19. Kellett CF, Boscainos PJ, Maury AC, Pressman A, Cayen B, Zalzal P, Backstein D, Gross A (2007) Proximal femoral allograft treatment of Vancouver type-B3 periprosthetic femoral fractures after total hip arthroplasty. Surgical technique. J Bone Joint Surg Am 89:68–79

    Article  PubMed  Google Scholar 

  20. Maury AC, Pressman A, Cayen B, Zalzal P, Backstein D, Gross A (2006) Proximal femoral allograft treatment of Vancouver type-B3 periprosthetic femoral fractures after total hip arthroplasty. J Bone Joint Surg Am 88:953–958

    Article  PubMed  Google Scholar 

  21. Hresko MT, McCarthy JC, Goldberg MJ (1993) Hip disease in adults with Down syndrome. J Bone Joint Surg Br 75:604–607

    PubMed  CAS  Google Scholar 

  22. Gill CE, Taylor HM, Lin KT, Padaliya BB, Newman WJ, Abramovitch AI, Richardson CR, Charles PD (2006) Difficulty in securing treatment for degenerative hip disease in a patient with Down syndrome: the gap remains open. J Natl Med Assoc 98:93–96

    PubMed  Google Scholar 

  23. Goodman S, Pressman A, Saastamoinen H, Gross A (2004) Modified sliding trochanteric osteotomy in revision total hip arthroplasty. J Arthroplasty 19:1039–1041

    Article  PubMed  Google Scholar 

  24. Gross AE, Goodman S (2004) The current role of structural grafts and cages in revision arthroplasty of the hip. Clin Orthop Relat Res 429:193–200

    Article  PubMed  Google Scholar 

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Acknowledgements

The authors would like to thank Matthew Macdonald at the Mount Sinai Orthopedic Department for his support in statistical analysis and data collection for our study.

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Correspondence to Yona Kosashvili.

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Kosashvili, Y., Taylor, D., Backstein, D. et al. Total hip arthroplasty in patients with Down’s syndrome. International Orthopaedics (SICOT) 35, 661–666 (2011). https://doi.org/10.1007/s00264-010-1030-8

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  • DOI: https://doi.org/10.1007/s00264-010-1030-8

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