The number of young patients, under the age of 55, who undergo total hip arthroplasty has risen considerably in recent years. We know that in older age groups the technique of total hip arthroplasty has shown excellent results. The literature, however, does not yet provide enough data on the prognosis of younger patients, and particularly of those under the age of 55, who undergo such an operation.
A new study set out to answer this question by reviewing the current literature on the indications, the choice of implants, their long-term survival, the rate of complications and of revision operations, and the radiological and functional results of total hip arthroplasty in patients under the age of 55.
A systematic search was made of the Embase and Medline medical databases in the English language, covering studies published between 2000 and 2018 that report the results of primary total hip arthroplasty in patients under the age of 55, with a minimum follow-up of 10 years.
32 studies were selected, containing 3,219 total hip arthroplasties in 2,434 patients. The most common preoperative diagnoses were necrosis of the femoral head, osteoarthritis and developmental dysplasia of the hip.
The implants chosen were modular implants, uncemented implants and metal-on-polyethylene bearing surfaces. The five-year and ten-year survival rates were 98.7% and 94.6% respectively. The rates of dislocation, deep infection and revision for any cause were 2.4%, 1.2% and 16.3% respectively. The mean Harris Hip Score improved from 43.6/100 to 91/100.
The study showed that total hip arthroplasty in patients under the age of 55 gives reliable results. Future studies should nevertheless assess the corresponding results at ten, fifteen and twenty years.
Source: “Canadian Journal of Surgery”, August 2019