Outcome of Primary total Hip Replacement in Patients Less than 50 Years Old

Abstract

We reviewed 33 primary total hip replacements in 24 patients younger than 50 years old. The mean age was 39.5 years and the follow-up averaged 6.1 years. There were 15 men and 9 women. Twenty-five hip replacements were cemented and 8 were uncemented. The most common hip pathology was osteonecrosis of the femoral head (36%), followed by rheumatoid arthritis (27%) and osteoarthritis (21%). Good pain relief was obtained in 70% of hips. Thigh pain developed in 2 uncemented hips and another had increasing hip pain. Function was good in 64% and 67% had good hip mobility. The best results were obtained in osteonecrosis of the femoral head, followed by osteoarthritis and rheumatoid arthritis. The commonest indication for revision was loosening of the acetabular component. Survival analysis of the 25 cemented hips showed a failure of 35% at 6 years and 9.1% at 8 years. Total hip replacement in young patients provides good pain relief and function although there is a limited time expectancy for good results.