Midterm results of cementless total hip arthroplasty in young

Abstract

Introduction: There are a variety of etiological factors that may result in arthritis of the hip in young adults. There are, therefore, not infrequent occasions when orthopedic surgeons may encounter very young patients with end-stage arthritis of the hip necessitating surgical intervention. In the past hip arthrodesis or resection arthroplasty were used to address end-stage arthritis of the hip in young patients but recently total hip arthroplasty emerged as the viable alternative to above surgical procedures. The high activity level, repetitive loading and excessive demand placed on the hip on one hand and issues of durability of the implant materials on the other lead to high failure rates of total hip arthroplasty in young patients in the past. The aim of this prospective study was to evaluate the clinical and radiographic results of these modern cementless THA in patients with end stage arthritis who were younger than 40 years of age. Materials and Methods: A prospective study was carried out in which 25 patients (28 hips) younger than 40 years with hip arthritis underwent primary cementless total hip arthroplasties participated. The Taperloc femoral component with Porous coated cementless acetabular cup and highly crossed linked polyethylene liner was used in all hips. The Harris hip score was used to determine functional outcome and activity level was evaluated by the classification of Johnston et al. Radiographic analysis consisted of antero-posterior views of the hip and pelvis, a true lateral view of the hip. Observations and Results: All 25 patients were available for both clinical and radiographic evaluation. 93% of patients had excellent to good; and none of the hips had poor clinical outcome. Radiographic assessment revealed consistent evidence of bony ingrowth. No femoral component was loose or required revision. Conclusion: Cementless total hip arthroplasty can be safely and successfully performed in young patients less than 40 years with excellent results in short to midterm follow-up.