Abstract
Background: Total hip replacement in patients of younger age with higher levels of activity increases the risk of loosening and mechanical failure. Patients and Methods: Fifty patients 34 male and 16 (62 hips) with mean age of 24 years received a primary total hip replacement. The etiology for operation was juvenile rheumatoid arthritis in 10 patients, ankylosing spondylitis in 20, and posttraumatic hip arthritis in 20. Cementless total hip replacement was used in 36 patients (42 hips); hybrid (cementless cup and cemented stem) was used in 14 patients (20 hips). Merle d'Aubigne score was used for clinical evaluation preoperative and at the last follow up. DeLee and Charnley criteria of acetabulum were used to assess the acetabular stability. Gruen et al. zones of femoral stem were recoded to monitor loosening. Results: The mean follow up duration was 9.5 years (range, 7 to 10.5 years). The mean pre-operative Merle d'Aubigne score was significantly improved from 6. 5 (SD 2.34) preoperatively to 16.5 (SD 1.56) 1-year postoperatively (P<0.001). Osteointegration of the stem was noted in 45 cases (57 hips) at the end one year of follow-up. By the end of follow up there were radiolucent lines in two to three of Gruen zones around the stem, and it was progressive in 10 patients without need of revision. Subsidence of more than 5 mm occurred in 8 hips 4 of them had revision and the other 4 were not revised until the end of follow up. Conclusion: Total hip arthroplasty in very patients has an excellent long term results up to 89.7% survival after 10.5 years of follow up. We recommend other prospective studies with homogenous populations with the same pathology and the type of implant.
Highlights
Secondary osteoarthritis in very young patients in the last decade has been treated using total hip arthroplasty with a proven long-term outcome [1]
Subsidence of more than 5 mm occurred in 8 hips 4 of them had revision and the other 4 were not revised until the end of follow up
Total hip arthroplasty in very patients has an excellent long term results up to 89.7% survival after 10.5 years of follow up
Summary
Secondary osteoarthritis in very young patients in the last decade has been treated using total hip arthroplasty with a proven long-term outcome [1]. Due to the underlying diseases in these young patients, the secondary osteoarthritis is often associated with loss of bone stock in the acetabular side The higher levels of activity among those patients increase the risk of loosening and mechanical failure [4]. The implant which can be used in the younger age group should have long-term clinical outcome easy revision without defect in bone stock. Total hip replacement in patients of younger age with higher levels of activity increases the risk of loosening and mechanical failure
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