Abstract
Purpose: To determine the current arthroplasty practice in osteoarthritic patients aged 55yrs or less for the population registered on the Trent & Wales Arthroplasty Database and stimulate debate. Is there a ‘gold standard’? If there is what is it ?
Method: The Trent Arthroplasty Audit Group collects prospective data on all hip arthroplasty surgery performed in Trent Region & North & West Wales (population 6.2 million). In 2000/2001 9.4% of the primary T.H.Rs and 14.1% of the revision T.H.Rs were aged 55yrs or less. We analysed the database to produce the following results.
Results: In 2000/01 385 primary T.H.Rs were performed on patients aged< 55yrs. 52% of the patients were male, the mean age at surgery was 48.3 yrs (Range 30–55yrs). 12% of the patients had a metal on metal hip resurfacing implant. In 39% both the femoral and acetabular components were uncemented. 14% had a hybrid combination. In 36% of cases the femoral and acetabular components were made by different manufacturers.
The bearing surfaces chosen were: metal / metal in 13%, metal on poly in 56%, ceramic on poly in 28% (Zirconia in 7.4%) and ceramic on ceramic in 3%. Low viscosity cement was used with 28% of femoral components and 19% of acetabular components. The predominant femoral head size was 28 mm.(49%) (22mm in 23%).
Conclusion: Surgeons strive to use up-to-date technology in young patients in an attempt to prolong the life of their hip replacement. At the present time we don’t appear to have a clear picture as to what is the ‘gold standard’ for young patients. How much evidence do we need before implanting a new implant or combination?
These abstracts were prepared by Mr Peter Kay. Correspondence should be addressed to him at The Hip Centre, Wrightington Hospital, Appley Bridge, Wigan, Lancashire WN6 9EP.
