Mid-Term Outcomes of Cementless Total Hip Arthroplasty in Adult Patients with Childhood Hip Infection

Abstract

Background Patients with hip joint infections in childhood often have many aftereffects of different degrees, regardless of the kind of treatment or natural course. Total hip arthroplasty is currently the most effective treatment for sequelae of childhood hip septic or tuberculous infection. This is a mid-term follow-up study of treatment results of patients who had undergone total hip arthroplasty (THA) with cementless prostheses. Material/Methods We retrospectively analyzed and followed 45 patients (45 hips) who underwent THA with cementless prostheses between 2010 and 2017. There were 45 patients, including 17 men and 28 women. The average age of the patients was 46 years (range, 18–67 years). All hip infections occurred in early childhood or adolescence, and the mean interval between initial infection and THA was 38.2 years (range, 15–60 years). The mean follow-up was 6.1 years (range, 2.7–9.5 years). Results Two patients underwent revision surgery because of loosening of the prosthesis, and 1 patient underwent revision surgery because of a new infection with no relationship with childhood infection during the follow-up. The average Harris hip scores significantly increased from 43.1 to 86.4 ( P <0.01), and the average visual analog scale significantly increased from 4.6 to 1.7 ( P <0.01). The hip dysfunction and osteoarthritis outcome scores were also significantly changed ( P <0.01) at the final follow-up. There were 2 cases of transient sciatic nerve palsy and intraoperative periprosthetic fractures in 3 cases. During follow-up, single revision was performed after 6 years of primary arthroplasty because of aseptic loosening in 2 cases and prosthesis infection in 1 case, which was not related to childhood pathogens. Conclusions THA for patients with sequelae of hip joint infection has a satisfactory effect that can effectively relieve joint pain and improve hip function. The recurrence rate of infection after either pyogenic infection or tuberculous is very low. The mid-term outcomes of THA in this setting were satisfactory, with high prosthesis survivorship and hip function scores.

Clinical outcome in total hip arthroplasty for septic sequelae in childhood

“…5,7,[10][11][12][13] The results of the present study are consistent with other published studies, and further strengthen the existing evidence (Table II). 5,7,[23][24][25][26][27] There was substantial pain relief and functional improvement after THA at an average follow-up of 6.5 years, as demonstrated by improvement in clinical scores and quality of life indices. The lower preoperative score suggests a greater chance of improvement after THA.…”

“… 5 , 7 , 10 - 13 The results of the present study are consistent with other published studies, and further strengthen the existing evidence ( Table II ). 5 , 7 , 23 - 27 …”

Total hip arthroplasty in patients with common pediatric hip orthopedic pathology

“…A 2021 systematic review examined the outcomes of THA in patients treated for osteoarticular infection. [48][49][50][51] The authors conducted a literature search (1993-2023) that included recent studies and analyzed various aspects of the topic.…”