Total joint replacement in adolescents: literature review and case examples

The current review summarizes the recent studies of total knee and hip replacement outcomes in adolescent patients, as well as highlights current replacement strategies and bearing options.

The survival rates of total knee and hip replacements in adolescents are lower compared with those in the elderly adults. Adolescent patients almost inevitably require revision surgery in their lifetime. Cementless arthroplasty is a promising replacement strategy in adolescents because, theoretically, if bone ingrowth occurs, then implant survival should improve; further, if revision is required, the surgeon does not have the burden of removing cement. However, recent data suggest no difference in survival rates between cementless and cemented implants in the short-term. The advantages and disadvantages between various bearing surfaces in this population also remain controversial and survival data are limited.

Total knee and hip replacement, although rare in the adolescent population, is successful at alleviating pain and restoring mobility in end-stage arthritic disease in the short-term. Numerous replacement strategies and bearing options are currently available; however, there is currently no standard of care or implants specifically designed for the adolescent population. Long-term studies looking at the survival of the various prostheses is essential to determine the efficacy and safety in the adolescent population with different causes of end-stage arthritic disease.