Skip to main content

Advertisement

SpringerLink
Log in

Is the Revision Rate Higher After Hip Arthroplasty in Teenage Patients? A Prospective Study with Long-Term Follow-Up of More Than 10 Years

  • Original Article
  • Published:
Indian Journal of Orthopaedics Aims and scope Submit manuscript

Abstract

Background

Total hip arthroplasty (THA) and hip resurfacing arthroplasty (HRA) are already proven good for end-stage arthritis in the older populations but it is challenging in young teenage patients. The primary aim was to assess Hip Disability and Osteoarthritis Outcome Score (HOSS), Harris Hip Score (HHS) and secondary aim for implant survival rate.

Materials and Methods

The details of 33 teenage patients (forty hips) who underwent HRA (21) and THA (19) at our institution (January 2002 to December 2013) with a mean follow-up period of 11.00 years (range 7.00–18.40) were included. The study group had 25 males and eight females.

Results

The overall median HOOSs with interquartile range were 89.00 (87.63–0.00). The median HOOSs at follow-up were as follows: 95.00 (90.00–95.00) for symptoms, 92.00 (90.00–95.00) pain, 87.00 (85.00–90.00) for functions, 81.00 (75.00–85.00) for sports and 94.00 (88.00–95.00) for QOL. HHS improved significantly from 36.88 ± 6.14 to 90.12 ± 6.56 (p < 0.001). The HHS of HRA group improved from 36.29 ± 5.83 to 89.38 ± 5.23 and THA group improved from 37.26 ± 6.22 to 90.94 ± 7.84. The 5-year radiological follow-up X-rays did not show any radiolucent line wider than 2 mm in all three zones of the acetabulum and no progressive subsidence or migration of > 1 mm and divergent radiopaque line in femur. The Implant survival rate for HRA was 100% at 5 years, 100% at 10 years, 92% at 15 years and THA group was 100% at 5 years and 90% at 10 years.

Conclusion

Our study showed a disability rate of zero with improved HOSS and HHS. The overall implant survival rate was good with 100% at 5 years, 97% at 10 years and 89.9% at 15 years in contrast to the previous studies with the use of modern implants and newer standard surgical techniques.

Level of Evidence

A Level II study http://www.spine.org/Documents/LevelsofEvidenceFinal.pdf.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8
Fig. 9

Similar content being viewed by others

Data Availability

Obtained.

Code availability

Obtained.

References

  1. Learmonth, I. D., Young, C., & Rorabeck, C. (2007). The operation of the century: total hip replacement. The Lancet, 370(9597), 1508–1519.

    Article  Google Scholar 

  2. Shan, L., Shan, B., Graham, D., & Saxena, A. (2014). Total hip replacement: a systematic review and meta-analysis on mid-term quality of life. Osteoarthritis and Cartilage, 22(3), 389–406.

    Article  CAS  Google Scholar 

  3. Bischel, O., Seeger, J. B., Krüge, M., & Bitsch, B. G. (2012). Multiple acetabular revisions in THA—poor outcome despite maximum effort. The Open Orthopaedics Journal, 6(1), 488–494.

    Article  CAS  Google Scholar 

  4. Stover, M. D., Beaul, P. E., Matta, J. M., & Mast, J. W. (2004). Hip arthrodesis: a procedure for the new millennium? Clinical Orthopaedics and Related Research, 418, 126–133.

    Article  Google Scholar 

  5. Clohisy, J. C., Oryhon, J. M., Seyler, T. M., et al. (2010). Function and fixation of total hip arthroplasty in patients 25 years of age or younger. Clinical Orthopaedics and Related Research, 468(12), 3207–3213.

    Article  Google Scholar 

  6. Adelani, M. A., Keeney, J. A., Palisch, A., Fowler, S. A., & Clohisy, J. C. (2013). Has total hip arthroplasty in patients 30 years or younger improved? A systematic review. Clinical Orthopaedics and Related Research, 471(8), 2595–2601.

    Article  Google Scholar 

  7. Restrepo, C., Lettich, T., Roberts, N., Parvizi, J., & Hozack, W. J. (2008). Uncemented total hip arthroplasty in patients less than twenty-years. Acta Orthopaedica Belgica, 74(5), 615–622.

    PubMed  Google Scholar 

  8. Treacy, R. B. C., McBryde, C. W., Shears, E., & Pynsent, P. B. (2011). Birmingham hip resurfacing. The Journal of Bone And Joint Surgery British Volume, 93-B(1), 27–33.

    Article  Google Scholar 

  9. Daniel, J., Pradhan, C., Ziaee, H., Pynsent, P. B., & McMinn, D. J. W. (2014). Results of Birmingham hip resurfacing at 12 to 15 years. The Bone & Joint Journal, 96-B(10), 1298–1306.

    Article  CAS  Google Scholar 

  10. Multani, I. S., Cunningham, I. K. T., & Walter, W. L. (2020). My current indications for hip resurfacing. Annals of Joint, 5, 14.

    Article  Google Scholar 

  11. McMinn, D. J., Daniel, J., Ziaee, H., & Pradhan, C. (2011). Indications and results of hip resurfacing. International Orthopaedics, 35(2), 231–237.

    Article  CAS  Google Scholar 

  12. Shrader, M. W. (2012). Total hip arthroplasty and hip resurfacing arthroplasty in the very young patient. Orthopedic Clinics of North America, 43(3), 359–367.

    Article  Google Scholar 

  13. National Joint Registry for England, Wales, Northern Ireland, and Isles of Man. National Joint Registry NJR 16th Annual Report, 2019

  14. Australian Orthopaedic Association National Joint Replacement Registry. Annual Report 2018. https://aoanjrr.sahmri.com/annual-reports-2018

  15. Flugsrud, G. B., Nordsletten, L., Espehaug, B., Havelin, L. I., & Meyer, H. E. (2007). The effect of middle-age body weight and physical activity on the risk of early revision hip arthroplasty: a cohort study of 1,535 individuals. Acta Orthopaedica, 78(1), 99–107.

    Article  Google Scholar 

  16. Adelani, M. A., Crook, K., Barrack, R. L., Maloney, W. J., & Clohisy, J. C. (2013). What is the prognosis of revision total hip arthroplasty in patients 55 years and younger? Clinical Orthopaedics and Related Research, 472(5), 1518–1525.

    Article  Google Scholar 

  17. Swarup, I., Lee, Y.-y, Chiu, Y.-f, Sutherland, R., Shields, M., & Figgie, M. P. (2018). Implant survival and patient-reported outcomes after total hip arthroplasty in young patients. The Journal of Arthroplasty, 33(9), 2893–2898.

    Article  Google Scholar 

  18. Tsukanaka, M., Halvorsen, V., Nordsletten, L., et al. (2016). Implant survival and radiographic outcome of total hip replacement in patients less than 20 years old. Acta Orthopaedica., 87(5), 479–484.

    Article  Google Scholar 

  19. MacLean, S., Evans, S., Pynsent, P., & O’Hara, J. (2015). Mid-term results for hip resurfacing in patients under 30 years old with childhood hip disorders. Acta Orthopaedica Belgica., 81(2), 264–273.

    PubMed  Google Scholar 

  20. Walker, R. P., Gee, M., Wong, F., et al. (2016). Functional outcomes of total hip arthroplasty in patients aged 30 years or less: a systematic review and meta-analysis. HIP International., 26(5), 424–431.

    Article  Google Scholar 

  21. Pakos, E. E., Paschos, N. K., & Xenakis, T. A. (2014). Long term outcomes of total hip arthroplasty in young patients under 30. The Archives of Bone and Joint Surgery, 2(3), 157–162.

    PubMed  PubMed Central  Google Scholar 

  22. Kanniyan, K., Patil, S., Ashok Kumar, P. S. A., Suryanaryan, P., & Bose, V. C. (2020). Does the femoral head size influence outcomes after uncemented total hip arthroplasty for fused hips? A prospective study in ankylosing spondylitis. JOIO. https://doi.org/10.1007/s43465-020-00210-7.

    Article  Google Scholar 

  23. Nilsdotter, A. K., Lohmander, L. S., Klässbo, M., Roos, E. M. (2003). Hip disability and osteoarthritis outcome score (HOOS)—validity and responsiveness in total hip replacement. BMC Musculoskeletal Disorders, 4(1)

  24. Hannouche, D., Devriese, F., Delambre, J., et al. (2015). Ceramic-on-ceramic THA implants in patients younger than 20 years. Clinical Orthopaedics and Related Research, 474(2), 520–527.

    Article  Google Scholar 

  25. D’Ambrosi, R., Marciandi, L., Frediani, P. V., & Facchini, R. M. (2016). Uncemented total hip arthroplasty in patients younger than 20 years. Journal of Orthopaedic Science, 21(4), 500–506.

    Article  Google Scholar 

  26. Backman, C. L. (2006). Arthritis Research & Therapy., 8(6), 221.

    Article  Google Scholar 

  27. Finkbone, P. R., Severson, E. P., Cabanela, M. E., & Trousdale, R. T. (2012). Ceramic-on-ceramic total hip arthroplasty in patients younger than 20 years. The Journal of Arthroplasty, 27(2), 213–219.

    Article  Google Scholar 

  28. Min, B.-W., et al. (2009). Femoral osteolysis around the unrevised stem during isolated acetabular revision. Clinical Orthopaedics and Related Research, 467(6), 1501–1506. https://doi.org/10.1007/s11999-008-0499-6.

    Article  PubMed  Google Scholar 

  29. Engh, C. A., Glassman, A. H., & Suthers, K. E. (1990). The case for porous-coated hip implants. The femoral side. Clinical Orthopaedics and Related Research., 261, 63–81.

    Google Scholar 

  30. Tsikandylakis, G., Mohaddes, M., Cnudde, P., Eskelinen, A., Kärrholm, J., & Rolfson, O. (2018). Head size in primary total hip arthroplasty. EFORT Open Reviews., 3(5), 225–231.

    Article  Google Scholar 

  31. Nordsletten, L., Tsukanaka, M., Halvorsen, V., Engesaeter, I., Engesaeter, L. B., Fenstad, A. M., & Rohrl, S. M. (2018). Total hip arthroplasty in patients younger than 20 years. Orthopaedic Proceedings, 100-B(SUPP_1), 47–47.

    Google Scholar 

  32. Sakellariou, V. I. (2014). Management bone loss of the proximal femur in revision hip arthroplasty: update on reconstructive options. World Journal of Orthopedics., 5(5), 614.

    Article  Google Scholar 

  33. Van de Velde, S. K., Loh, B., & Donnan, L. (2017). Total hip arthroplasty in patients 16 years of age or younger. Journal of Children’s Orthopaedics, 11(6), 428–433. https://doi.org/10.1302/1863-2548.11.170085.PMID:29263754;PMCID:PMC5725768.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Acknowledgements

Mr. Raj, Research & Medical Documentation Incharge, Asian Joint Reconstruction Institute @ SIMS Hospitals, Chennai, India (rajdeltapro@gmail.com).

Funding

No specific financial support was received for this study.

Author information

Authors and Affiliations

  1. Asian Joint Reconstruction Institute, AJRI @ SIMS Hospitals, Chennai, Tamil Nadu, India

    Vijay C. Bose, Kanniyan Kalaivanan, Ashok Kumar & P. Suryanarayan

  2. Gleneagles Global Hospital, Chennai, Tamil Nadu, India

    Mithun Manohar

  3. SRM Medical College, SRM IST, Kattankulathur, Tamil Nadu, India

    Shantanu Patil

Authors
  1. Vijay C. Bose
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Kanniyan Kalaivanan
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Mithun Manohar
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Ashok Kumar
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Shantanu Patil
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. P. Suryanarayan
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

VCB, MS Ortho: chief operating surgeon. KK, MS Ortho: operating surgeon, manuscript writing, MM, MS Ortho: manuscript writing, data collection, and statistics. AK and PS, MS Ortho: operating surgeon and data collection. SP, MS Ortho: statistics workup and manuscript writing. PS, MS Ortho: chief operating surgeon.

Corresponding author

Correspondence to Kanniyan Kalaivanan.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

Institutional Ethical Committee approval was obtained.

Consent for study

The study was approved by SIMS Institutional Review Board and informed consent from patients was obtained.

Consent to participate

Obtained as per institutional policy.

Consent for publication

Obtained as per institutional policy.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Bose, V.C., Kalaivanan, K., Manohar, M. et al. Is the Revision Rate Higher After Hip Arthroplasty in Teenage Patients? A Prospective Study with Long-Term Follow-Up of More Than 10 Years. JOIO 55, 993–1002 (2021). https://doi.org/10.1007/s43465-021-00370-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s43465-021-00370-0

Keywords

Search

Navigation