Total hip arthroplasty in children with osteoarthritis: A retrospective cohort study

Total hip arthroplasty (THA) is a rare procedure in pediatric patients. Although it shows excellent results in adults, the presence of growth plates, the limited longevity of implants, and the hip-spine biomechanics involved during growth make the outcomes of THA in children uncertain.

We hypothesized that THA yields satisfactory results for children suffering from unmanageable pain due to hip joint osteoarthrosis.

27 patients aged <18 years who underwent THA for hip joint osteoarthritis at our hospital between 2015 and 2022 were retrospectively included. Primary outcomes included two clinical scales: the Postel Merle d'Aubigné (PMA) and Oxford scale. Secondary outcomes included chronic pain relief and complications.

Mean age at surgery was 13.7± 1.7 years (min11, max 17). The mean follow-up was 5.4±2.4 years (min 3, max 10). Etiology of osteoarthrosis was slipped capital femoral epiphysis (n=13), idiopathic hip chondrolysis (n=4), femoral neck fracture (n=3), developmental hip dysplasia (n=3), hip joint infection (n=2), aseptic osteonecrosis secondary to drepanocytosis (n=1), and Legg-Calvé-Perthes disease (n=1). The average Oxford score was 43.2±4.8, and the mean PMA score was 15.9±0.6. Pain relief was achieved in 96.3% of patients. Six patients had major complications (22.2%), with three (11.1%) requiring unplanned surgeries.

The main limitations were a small sample size and the absence of a control group.

To date, no study has specifically evaluated THA clinical outcomes in children with non-inflammatory hip joint osteoarthritis. This study demonstrates satisfactory outcomes following THA in children with hip joint osteoarthritis. THA should be considered a viable option for selected pediatric patients.