Has Total Hip Arthroplasty in Patients 30 Years or Younger Improved? A Systematic Review

Adelani, Muyibat A.; Keeney, James A.; Palisch, Allison; Fowler, Susan A.; Clohisy, John C.

doi:10.1007/s11999-013-2975-x

Cited by 110 publications

(93 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…A systematic review of THA performed in patients 30 years or younger found that clinical results improved little after surgery and did not differ during the past two decades compared with historical controls [1]. Adelani et al [1] stated that limited improvement in pain and function in these patients might be explained by poor overall health status and underlying systemic diseases; however, most of the studies included in our review focused on cemented THA for treating patients with juvenile rheumatoid arthritis, a situation less likely to occur today with the introduction of modern antirheumatic drugs. Clohisy et al [10] reported on the function of 88 patients (102 hips) who had THAs and were 25 years or younger at the time of surgery.…”

Section: Discussionmentioning

confidence: 99%

“…However, many surgeons are reluctant to perform THAs in young adults because the population has been long considered at higher risk for revision surgery than the elderly population [27,33,38,39,44]. Adelani et al [1] reported that earlier studies evaluated mainly results of THA in patients with juvenile rheumatoid arthritis and the use of cemented implants and conventional polyethylene that potentially contributed to component failure. In addition, the presence of morphologic deformities in patients who have undergone previous femoral or pelvic procedures in childhood may make THAs in these patients more difficult, more complicated, or less durable.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Ceramic-on-ceramic THA Implants in Patients Younger Than 20 Years

Hannouche

Devriese

Delambre

et al. 2016

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Ceramic-on-ceramic THA Implants in Patients Younger Than 20 Years

Hannouche

Devriese

Delambre

et al. 2016

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

show abstract

“…THA is now a viable option for younger, active, patients and those with a high body mass index [1]. With this population, effective THA requires preservation of the metaphyseal bone, effective femoral revision options, and easier insertion options through less invasive approaches [18,27,36,45].…”

Section: Introductionmentioning

confidence: 99%

Two- to 4-Year Followup of a Short Stem THA Construct: Excellent Fixation, Thigh Pain a Concern

Amendola

Goetz

Liu

et al. 2017

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

Background Short stem cementless femoral components were developed to aid insertion through smaller incisions, preserve metaphyseal bone, and potentially decrease or limit the incidence of thigh pain. Despite some clinical success, the senior author (DDG) believed a higher percentage of his patients who had received a cementless short stem design were experiencing thigh pain, which, coupled with concerns about bone ingrowth fixation, motivated the review of this case series.Questions/purposes (1) What is the proportion of patients treated with a short stem cementless THA femoral component that develop thigh pain and what are the hip scores of this population? (2) What are the radiographic results, specifically with respect to bone ingrowth fixation and stress shielding, of this design? (3) Are there particular patient or procedural factors that are associated with thigh pain with this short stem design? Methods Two hundred sixty-one primary THAs were performed in 238 patients by one surgeon between November 2010 and August 2012. During this time period, all patients undergoing primary THA by this surgeon received the same cementless short titanium taper stem. Seven patients (eight hips) died and five patients (five hips) were lost to followup, leaving 226 patients (248 hips) with a mean followup of 3 years (range, 2-5 years). Patients rated their thigh pain during activity or rest at final followup on a 10-point visual analog scale. Harris hip scores (HHS) were obtained at every clinic appointment. Thigh pain was evaluated at the final followup or by contacting the patient by phone. Radiographs were evaluated for boneimplant fixation, bone remodeling, and osteolysis. An attempt was made to correlate thigh pain with patient demographics, implant specifications, or radiographic findings. Results Seventy-six percent of hips (180 of 238) had no thigh pain, 16% of hips (37 of 238) had mild thigh pain, and 9% (21 of 238) had moderate or severe thigh pain. Preoperatively, mean HHS was 47 (SD, 16) and at last followup, mean HHS was 88 (SD, 13). There were two femoral revisions, one for severe thigh pain and the other for infection. All but two components demonstrated bone ingrowth fixation (99%). Femoral stress shielding was mild in 64% of hips (135 of 212), moderate in 0.5% (one of 212), and severe in no hips. There is an inverse linear

show abstract

“…There are few reports on the outcome of (THA) in young patients under the year of 30 with survival rates ranged from 49% to 95% [28][29][30][31]. The main reason for revision in all literature was aseptic loosening, but the majority of these studies are small number of cases and short-term follow up [32][33][34].…”

Section: Discussionmentioning

confidence: 99%