Abstract
Background
Surgeons always must take into account that a primary total hip arthroplasty (THA) in a young patient will be revised in the future, this because of the long life expectancy of young THA patients and the limited durability of prosthetic implants in these patients. Therefore we would like to accentuate the revisability of a primary THA in this specific and high demanding patient population.
Methods
343 consecutive THA in 267 patients under the age of 50 years were evaluated. We also assessed the results of the revised THA (n=53) within the same population. Clinical, radiographical and survival of primary and revision THA were evaluated.
Results
With no patient lost during follow-up, 53 primary hips were revised after a mean follow-up of 8.9 (range 2.0–19.3) years. Survival with endpoint revision for any reason of either component was 86% after 10 years for primary THA. The average follow-up of the revisions of this population was 4.2 (range 0.1–14.8) years and 3 hips needed a repeat revision. Survival was 91% after 5 years for the revision THA. As well after primary as revision THA showed good clinical outcome.
Conclusions
Cemented implants in young patients show satisfying results as well in primary as revision THA with good survival and clinical outcome. Keeping in mind that the young patient will outlive their primary THA, the primary has to be revisable and the results of the revision THA must be as good as the primary THA. Bone defects in primary and revision THA can be successful managed with impacted bone grafts, without the need for augments, cages or larger implants.
