The fate of cemented total hip arthroplasty in young patients

Forty-four cemented hip replacements in patients under 45 years of age were assessed clinically and radiologically five to ten years after implantation. Four of five hips were pain-free and provided excellent function, and one in seven hips required revision but have since fared well. The results for osteoarthritic hips were superior to those with rheumatoid disease. Critical examination of the roentgenograms revealed a higher level of loosening than was suspected clinically, with only one in two hips appearing entirely satisfactory. Although weight gain and previous surgery did not affect the outcome, patients who returned to heavy manual work or athletic activities soon developed loosening. Four of five young patients gained freedom from pain and became fully active at a time when mobility was of crucial importance to both their professional and family lives. Clearly, these results affirm the value of total hip arthroplasty (THA) in young patients with either osteoarthritis or rheumatoid arthritis, although a limited time expectancy of these good results undoubtedly does exist.