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Function and Fixation of Total Hip Arthroplasty in Patients 25 Years of Age or Younger

  • Symposium: Papers Presented at the 2009 Closed Meeting of the International Hip Society
  • Published:
Clinical Orthopaedics and Related Research®

Abstract

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.

Level of Evidence

Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

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Acknowledgments

We thank Gail Pashos and Debbie Long for their assistance with the manuscript preparation.

Author information

Authors and Affiliations

  1. Department of Orthopaedic Surgery, Washington University School of Medicine, One Barnes-Jewish Plaza, Suite 11300 West Pavilion, Campus Box 8233, St Louis, MO, 63110, USA

    John C. Clohisy MD & Jeremy M. Oryhon MD

  2. Wake Forest University Baptist Medical Center, Winston-Salem, NC, USA

    Thorsten M. Seyler MD

  3. Department of Orthopaedic Surgery, University of Iowa School of Medicine, Iowa City, IA, USA

    Christopher W. Wells BA, Steve S. Liu MD & John J. Callaghan MD

  4. Rubin Institute for Advanced Orthopedics, Center for Joint Preservation and Reconstruction Sinai Hospital, Baltimore, MD, USA

    Michael A. Mont MD

Authors
  1. John C. Clohisy MD
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  2. Jeremy M. Oryhon MD
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  3. Thorsten M. Seyler MD
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  4. Christopher W. Wells BA
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  5. Steve S. Liu MD
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  6. John J. Callaghan MD
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  7. Michael A. Mont MD
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Corresponding author

Correspondence to John C. Clohisy MD.

Additional information

One or more of the authors received funding from the Curing Hip Disease Fund (JCC) and Stryker Orthopedics (MAM), Mahwah, NJ, for this study. Each author certifies that he or she has or may receive payments or benefits from a commercial entity: DePuy (MAM, JJC), Stryker (MAM), Wright Medical (MAM), National Institutes of Health (NIAMS and NICHD) (MAM), and Tissue Gene (MAM) related to this work.

Each author certifies that his or her institution has approved the human protocol for this investigation, that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participation in the study was obtained.

This work was performed at Washington University School of Medicine, St Louis, MO, USA.

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Clohisy, J.C., Oryhon, J.M., Seyler, T.M. et al. Function and Fixation of Total Hip Arthroplasty in Patients 25 Years of Age or Younger. Clin Orthop Relat Res 468, 3207–3213 (2010). https://doi.org/10.1007/s11999-010-1468-4

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  • DOI: https://doi.org/10.1007/s11999-010-1468-4

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