Abstract
Introduction
Data on the outcome of THA in patients under the age of 30 years is sparse. There is a perceived reluctance to offer surgery to young patients on the basis of potential early failure of the implant. We aim to review our experience with THA in this group of patients to establish outcomes in a high volume specialist arthroplasty unit.
Material & methods
A retrospective review of prospectively collected data from the Lower Limb Arthroplasty Unit of patients who underwent THA <30 years of age between 1989–2009 was undertaken. Ninety five patients (117 THAs) were identified but 25 patients (27 hips) were excluded for lack of clinical records and 6 patients (9 hips) for follow up of <5 years. Clinical records were reviewed for patients’ age at operation, underlying pathology, details of operation and any failures (revision). Radiographs were reviewed for any evidence of loosening and wear of the components. Functional assessment was also carried out using the modified Hip disability & osteoarthritis outcome score (HOOS), Oxford hip score and EQ5D–5L.
Results
The mean age was 25 (16–30) years and 67% patients were females. The underlying pathologies included development dysplasia of the hip (28%), juvenile rheumatoid arthritis (27%), slipped capital femoral epiphyses, avascular necrosis of femoral head, Perthes’ disease and posttraumatic arthritis. Twenty-two patients (28%) have had a revision at 12.6 years (5–26 years), majority of them for aseptic loosening of the acetabular component.
Discussion
Higher failure rates has led many to be be very cautious when considering THA in the very young patients despite the significant improvement in function, quality of life and overall health arthroplasty offers. This study provides the mid-long term results of THA which is valuable when advising young patients on the prospects of revision surgery at the time of primary THA.
