Total hip replacement in patients younger than thirty years old. A five-year follow-up study.

Chandler, Hugh P.; Reineck, F T; Wixson, Richard L.; McCarthy, J.

doi:10.2106/00004623-198163090-00008

Cited by 600 publications

(189 citation statements)

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“…The results of cemented THAs with metal-on-polyethylene articulation in ON have not generally been satisfactory in studies reported with a similar age group and followup as our mean 5.5 years [5,7,10,24,26,28]. One study [7] reported an overall failure rate of 37% at a mean followup of 7.6 years in 28 cemented arthroplasties; a second study [28] reported unsatisfactory results in 14 of 29 ON hips (48%) compared with 16 of 63 (25%) in patients with OA, and a third study [26] had a poor outcome in 11 of 12 cemented ON hips.…”

Section: Discussioncontrasting

confidence: 46%

Metal-on-Metal Hip Arthroplasty Does Equally Well in Osteonecrosis and Osteoarthritis

Dastane

Long

Wan

et al. 2008

Clinical Orthopaedics &Amp; Related Research

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Many previous reports suggest total hip arthroplasty performs suboptimally in young patients with osteonecrosis. We retrospectively compared the performance of metal-on-metal articulation in a select group of 107 patients with 112 hips (98 uncemented and 14 cemented stems) 60 years of age or younger with either osteonecrosis (27 patients, 30 hips) or primary osteoarthritis (80 patients, 82 hips). We evaluated all patients with patient-generated Harris hip score forms and serial radiographs. Five mechanical complications were caused by impingement, two with pain, two dislocations, and one liner dissociation. At a minimum followup of 2.2 years (mean, 5.5 years; range, 2.2-11.7 years), we observed no osteolysis or aseptic loosening in the osteonecrosis group, whereas one osteoarthritic hip had cup revision for loosening (none showed evidence of osteolysis). None of the stems were loose. Patients with osteonecrosis or primary osteoarthritis were similar in clinical and radiographic performance. The patients with metal-on-metal hip arthroplasty for osteonecrosis had no revisions for aseptic loosening, but did have one liner change in a cup for painful impingement.

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Section: Discussioncontrasting

confidence: 46%

Metal-on-Metal Hip Arthroplasty Does Equally Well in Osteonecrosis and Osteoarthritis

Dastane

Long

Wan

et al. 2008

Clinical Orthopaedics &Amp; Related Research

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“…Our finding that older patients have a lower failure rate than younger patients confirms that of other authors [1,2,4].…”

Section: Discussionsupporting

confidence: 92%

Factors affecting socket fixation after cemented revision

Raut

Kay²,

Siney

et al. 1997

International Orthopaedics

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“…Historically, excessive body weight greater than 80 kg was associated with a higher rate of aseptic loosening in patients undergoing THA [32,83]. Recently, several studies by Amstutz et al [4,17,58] demonstrate greater patient weight is not associated with earlier component loosening and femoral neck fracture risk, and survivorship up to 5 years are similar between the obese (98.6%) and nonobese (93.6%) patients with metal-on-metal hip resurfacing.…”

Section: Obesitymentioning

confidence: 99%

Is Patient Selection Important for Hip Resurfacing?

Nunley¹,

Valle²,

Barrack³

2009

Clinical Orthopaedics &Amp; Related Research

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The optimal implant option for hip arthroplasty in the young, active patient remains controversial. There has been renewed interest for metal-on-metal hip resurfacing due to improved design and manufacturing of implants, better materials, enhanced implant fixation, theoretical advantages over conventional total hip arthroplasty, and recent Food and Drug Administration approval of two devices. Recent studies indicate satisfactory short-and midterm clinical results (1-to 10-year followup) with low complication rates, but there is a learning curve associated with this procedure, a more extensive surgical approach is necessary, and long-term results have yet to be determined. Proper patient selection may help avoid complications and improve patient outcomes. Patient selection criteria in the literature appear based predominantly on theoretical considerations without any consensus on stratifying patient risk. The most commonly reported complications encountered with hip resurfacing include femoral neck fracture, acetabular component loosening, metal hypersensitivity, dislocation, and nerve injury. At the time of clinical evaluation, patient age; gender; diagnosis; bone density, quality, and morphology; activity level; leg lengths; renal function; and metal hypersensitivity are important factors when considering a patient for hip resurfacing. Based on our review, we believe the best candidates for hip resurfacing are men under age 65 with osteoarthritis and relatively normal bony morphology. Level of Evidence: Level V, prognostic study. See the Guidelines for Authors for a complete description of levels of evidence.

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Total hip replacement in patients younger than thirty years old. A five-year follow-up study.

Cited by 600 publications

References 0 publications

Metal-on-Metal Hip Arthroplasty Does Equally Well in Osteonecrosis and Osteoarthritis

Metal-on-Metal Hip Arthroplasty Does Equally Well in Osteonecrosis and Osteoarthritis

Factors affecting socket fixation after cemented revision

Is Patient Selection Important for Hip Resurfacing?

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