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

Abstract

Total hip arthroplasty (THA) and hip resurfacing arthroplasty (HRA) are already proven goodfor end-stage arthritis in the older populations but it is challenging in young teenagepatients. The primary aim was to assess Hip Disability and Osteoarthritis Outcome Score (HOSS), Harris Hip Score (HHS) and secondary aim for implant survival rate. 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 11.00years (range 7.00-18.40) were included. The study group had 25 males and eight females. 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 2mm in all three zones of the acetabulum and no progressive subsidence or migration of > 1mm and divergent radiopaque line in femur. The Implant survival rate for HRA was 100% at 5years, 100% at 10years, 92% at 15years and THA group was 100% at 5years and 90% at 10years. Our study showed a disability rate of zero with improved HOSS and HHS. The overall implant survival rate was good with 100% at 5years, 97% at 10years and 89.9% at 15years in contrast to the previous studies with the use of modern implants and newer standard surgical techniques. A Level II study http://www.spine.org/Documents/LevelsofEvidenceFinal.pdf.