Uncemented total hip arthroplasty in patients less than twenty-years

A variety of conditions may lead to arthritis of the hip during adolescence. Although uncommon, total hip arthroplasty may occasionally be necessary for treatment of end-stage disabling arthritis of the hip in the young. There is paucity of information documenting the outcome of uncemented total hip arthroplasty in adolescents. We report our experience with total hip arthroplasty in patients under the age of twenty years. The results of 35 consecutive total hip arthroplasties performed at our institution in 25 patients between 1993 and 2003 were reviewed. There were 17 females and 8 males with a mean age of 17.6 years (range: 13.5 to 20). All patients received a Hydroxyapatite (HA) plasma sprayed Titanium acetabular component and a tapered femoral stem proximally coated with HA. Follow-up averaged 6.6 years (range: 4.2 to 10). The underlying diagnosis was avascular necrosis (16 hips), juvenile rheumatoid arthritis (9 hips), sequelae of DDH (2 hips), spondyloepiphyseal dysplasia (2 hips), sequelae of Perthes (2 hips), osteoarthritis (2 hips), post-traumatic arthritis (1 hip), and pseudo rheumatoid chondrodysplasia (1 hip). There was a significant improvement in function and relief of pain as measured by the Harris Hip score and SF-36. All uncemented components were found to be stable and osseo-integrated at the latest followup. There were no complications, or reoperations. There was one revision secondary to severe polyethylene wear. This patient was revised 10 years after the index surgery. Uncemented total hip arthroplasty was found to confer a significant improvement in function and to have an acceptable short-term outcome in very young patients with end-stage arthritis of the hip. Longer-term follow-up is needed to assess the durability of this procedure in adolescents.