Cemented Hip Replacements in Patients Younger than 50 Years: 16–24 Year Results

Abstract

Although specialist centres have recorded a 75% survivorship of hip arthroplasty after 20 years (1), results in general orthopaedic units are unreported. Thirty-four patients with 45 primary cemented total hip arthroplasties implanted by “first generation” cementing techniques were reviewed after a mean of 20 years, documenting revision, occupation, and function. Twenty of the 35 (57%) hips were revised after a mean of 12 (2 to 21) years and reviewed after a mean of 7.6 years. Three hips had been subsequently re-revised. Seven out of nine (78%) hip arthroplasties in males failed, compared with 13 of 26 (50%) in females. Eighty-five percent failed by aseptic loosening. Five of nine employed patients had retired or changed profession. The mean Harris Hip Score was 73% (unrevised), 75% (revised), and 64% (re-revised). These results justify continuing efforts to improve technique and prosthetic design. Over a quarter of our patients were lost to follow up despite repeated contact over the previous 18 years, which mirrors the world literature. To adequately assess modern designs and techniques, we must improve retrieval. A national database would assist this.

Treatment of the young active patient with osteoarthritis of the hip

“…Regardless of the reservations detailed in this study, the results of hip arthroplasty in younger patients are better than those previously reported with cemented total hip replacement, 51 in which there was a 14% revision rate after five years and 50% survival after 15 years. 52 Longer followup may establish whether the change of practice recorded here represents a true advance.…”

Beneficial and Limiting Factors Affecting Return to Work After Total Knee and Hip Arthroplasty: A Systematic Review

“…This review demonstrated that only three factors related to treatment of joint disease have been investigated with regard to the patient’s return to work: type of operation, patient restrictions, and discharge based on guidelines. Based on the literature on TKA and THA, the following factors have been suggested to be important in optimizing return to work after TKA or THA: comorbidity [ 24 , 25 ], previous TKA or THA, or either revision [ 22 ], type of component used [ 26 – 28 ], kind of disease [ 29 , 30 ], and possible treatment after surgery [ 20 ]. It goes without saying that the factors already identified require extra research as well.…”