Abstract
Aims: The goal was to determine if young patients respect the instructions for medical supervision control instructions after a total hip arthroplasty (THA). Methods:We performed 50 THA (Harris cups and ABG I stems) in 39 patients, mean age 38 years ± 11 (15–58). There were thirty-eight 28mm femoral heads (30 zirconia, 8 chromium-cobalt) and 12 chromium-cobalt heads in 22mm. Each patient was told how necessary a regular medical supervision was with the following schedule: controls at 2 months, 1 year then every two years. In 2000, all the patients were evaluated (no lost for follow-up). Wear was measured according to Livermore with a digitizer. Results: At 72 ± 14 months of follow-up (5–9 years), 51% of the patients (20/39) did not come back for the intermediate controls. No factor could be accounted for that, except being a male (p=0.04). Wear was rather severe (average 0.23 mm/year). 37% of the patients with a severe wear (> 0.2 mm/year) did not come back for intermediate controls and were all free of symptoms. There were 3 revisions because of wear (> 2 mm) and 3 others hips are awaiting revision because of wear. Three of these 6 patients did not come back for intermediate examination. The 28mm heads induced more wear than the 22mm heads (p=0.008). No other factor was related to how severe wear was (age, sex, activity or thickness of polyethylene inserts). Moreover the zirconia did not reduce wear. Conclusion: In spite of the recommendations, half of the patients did not respect the medical supervision schedule and that was unpredictable. We recommend a careful follow-up of young patients after a THA in order to detect wear (usually free of symptoms). Moreover our study underlined that the zirconia wasn’t so efficient to prevent wear phenomena.
Theses abstracts were prepared by Professor Dr. Frantz Langlais. Correspondence should be addressed to him at EFORT Central Office, Freihofstrasse 22, CH-8700 Küsnacht, Switzerland.
