Survivorship of Hip and Knee Implants in Pediatric and Young Adult Populations

Sedrakyan, Art; Romero, Lucas; Graves, Stephen; Davidson, D C; Steiger, Richard de; Lewis, Peter L.; Solomon, Michael; Vial, Robyn; Lorimer, Michelle

doi:10.2106/jbjs.n.00541

Cited by 44 publications

(61 citation statements)

References 33 publications

(11 reference statements)

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“…This finding is comparable with the reports on contemporary cementless THA in adolescents and young adults, which have shown stable implant fixation of femoral stems and acetabular components at intermediate follow-up. 15 , 19 , 21 - 23 …”

Section: Discussionmentioning

confidence: 99%

Total hip arthroplasty in patients 16 years of age or younger

Velde

Loh

Donnan

2017

Journal of Children's Orthopaedics

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PurposeTotal hip arthroplasty (THA) is rarely recommended in skeletally immature patients. The goal of the present study was to report our short- to mid-term results of THA in a series of children aged 16 years or younger, including clinical outcomes and post-operative complications, signs of radiographic loosening of the prostheses, and revision rate.MethodsThe 18 children (two male and 16 female patients, 24 hips) underwent cementless THA at a mean age of 14.6 years (11 to 16). Five patients had a bilateral, one-stage surgical procedure. Clinical assessment of these hips used the Merle d’Aubigné et Postel scale modified by Charnley to facilitate assessment of the function of walking. Clinical and radiographic follow-up was conducted at six weeks, six months and then yearly for the first three years. All post-operative complications were recorded.ResultsNo intra-operative or early post-operative complications occurred. At a mean follow-up of 3.8 years (1 to 8), all patients had greatly improved pain and function scores. All children in the present study improved from severely impaired gait, including four children who were wheelchair-bound, to completely unrestricted gait. All hips demonstrated good alignment with no evidence of wear or radiographic lucencies. No revision of components has been required. One patient had persistent adductor contracture which was addressed with adductor tendon release.ConclusionsTHA is a successful procedure for unsalvageable hip arthritis in children at a mean follow-up of 3.8 years. Long-term follow-up will be needed to determine implant longevity of the components in these children.

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Section: Discussionmentioning

confidence: 99%

Total hip arthroplasty in patients 16 years of age or younger

Velde

Loh

Donnan

2017

Journal of Children's Orthopaedics

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“…I n a study of 1536 children and young adults thirty years of age or younger who were operated on in Australia between 1999 and 2012, we found that patients who underwent hip and knee replacement had very different diagnoses compared with adults, including a high prevalence of tumor (http://dx.doi.org/ 10.2106/JBJS.N.00541) 22 . The revision surgery rate was similar for this population compared with that of older patients.…”

Section: Other Icor Studies Of Devices and Outcomesmentioning

confidence: 99%

National and International Postmarket Research and Surveillance Implementation

Sedrakyan

Paxton

Graves

et al. 2014

The Journal of Bone and Joint Surgery

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“…A review of the Australian registry reported a cumulative revision rate of 4.5% in 297 primary THAs performed in patients 20 years and younger. 3 However, the most common bearing utilized was ceramic-on-ceramic (40%), followed by metal-on-HXLPE (22%), and ceramic-on-HXLPE (8%). One study reported 96% survivorship at an average follow-up of 52 months in patients younger than 20 years with ceramic-onceramic THA, with one revision for acetabular loosening.…”

Section: Discussionmentioning

confidence: 99%

Total Hip Arthroplasty in Patients 21 Years and Younger Using Highly Cross-Linked Polyethylene: Excellent Survivorship at Five Years

et al. 2018

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The survivorship of contemporary total hip arthroplasty has improved substantially as a result of the success of highly cross-linked polyethylene. Nevertheless, there is limited information on its performance in extremely young patients. The purpose of this study is to evaluate the (1) clinical and radiographic outcomes, (2) polyethylene wear rates, and (3) mid-term survivorship of total hip arthroplasty in patients 21 years or younger using highly cross-linked polyethylene. After Institutional Review Board approval, the authors identified 45 patients aged 21 years or younger (56 hips) who underwent primary total hip arthroplasty with highly cross-linked polyethylene at their institution by the senior author between 2000 and 2009. Patients were followed for a minimum of 2 years, or until revision. At a mean follow-up of 57 months, modified Harris Hip Scores, Western Ontario McMaster Universities Arthritis Index scores, Short Form-12 physical function scores, and University of California, Los Angeles activity scores improved significantly in all patients. There was no radiographic evidence of osteolysis in any patient. The mean linear polyethylene wear rate was 0.02 mm per year. Survivorship was 98% with one revision for acetabular loosening at 71 months. Total hip arthroplasty in patients 21 years or younger with highly cross-linked polyethylene had excellent clinical and radiographic outcomes at mid-term follow-up. Longer-term data are needed in this patient population to confirm continued survivorship in the extremely young. The level of evidence used for this study was level III.

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Survivorship of Hip and Knee Implants in Pediatric and Young Adult Populations

Cited by 44 publications

References 33 publications

Total hip arthroplasty in patients 16 years of age or younger

Total hip arthroplasty in patients 16 years of age or younger

National and International Postmarket Research and Surveillance Implementation

Total Hip Arthroplasty in Patients 21 Years and Younger Using Highly Cross-Linked Polyethylene: Excellent Survivorship at Five Years

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