Hip Replacement in Children with Femoral Head Collapse and Hip Joint Degeneration—Two Case Reports

Abstract

There are several pathological conditions in children, such as Legg-Calvé-Perthes disease, slipped capital femoral epiphysis, and femoral head avascular necrosis, which can progress to disabling hip joint destruction. These children undergo surgeries, such as hip arthrodesis, in an attempt to postpone hip replacement so that it can be done at an older age. Unfortunately, hip arthrodesis significantly limits their ability to actively engage in activities that require full hip mobility. For these children, active participation in games and sports activities remains an important factor for their physical development and mental health. On the contrary, hip arthroplasty can ensure a pain-free, unrestricted range of hip movement, but are doubts as to its viability over time, especially in young people who exhibit intense activity. We report successful hip replacement in two children, fourteen years of age and younger, with femoral head collapse and disabling joint degeneration due to avascular necrosis of the femoral head, whom the hip replacement was considered the only surgical treatment ensuring a painless hip joint. For the clinical assessment of these two hips, we used the online Harris hip score, preoperatively and postoperatively. No intraoperative or early postoperative complications occurred. Follow-up was conducted at six weeks, six months, and then at an annual clinical and radiological evaluation. At the final seven-year follow-up, these two children had greatly improved their function hip score considerably. Hip arthroplasty can ensure a pain-free, unrestricted range of hip movement in young children when their hip joint is severely affected.