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Total hip replacement without cement for non-inflammatory osteoarthrosis in patients who are less than forty-five
M A Mont1, D C Maar, K A Krackow
1Department of Orthopaedic Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Insights
Total hip arthroplasty without cement shows high success rates in patients under 45 with non-inflammatory osteoarthrosis. This procedure offers excellent functional outcomes and a low complication rate in the studied group.
Area of Science:
- Orthopedic Surgery
- Biomaterials Science
Background:
- Non-inflammatory osteoarthrosis affects younger patients, necessitating joint replacement.
- Total hip arthroplasty (THA) is a common treatment for hip osteoarthritis.
- Cementless THA aims to improve long-term implant fixation and patient outcomes.
Purpose of the Study:
- To evaluate the clinical and radiographic outcomes of cementless total hip arthroplasty.
- To assess the success rate of cementless THA in patients younger than 45 years.
- To determine the durability and complication profile of cementless hip implants in this demographic.
Main Methods:
- A retrospective study of 42 patients (44 hips) who underwent cementless THA.
- Patients were followed for 3 to 7 years (average 4.5 years).
- Outcomes were assessed using the Harris hip score and radiographic evaluation.
Main Results:
- 84% of hips achieved an excellent Harris rating post-surgery.
- The mean Harris hip score improved significantly from 43 to 92.
- A low complication rate of 5% requiring revision was observed.
Conclusions:
- Cementless total hip arthroplasty demonstrates a high success rate in patients under 45 with non-inflammatory osteoarthrosis.
- The procedure provides excellent functional improvement and durability in the short to medium term.
- Further long-term studies are warranted to confirm sustained outcomes.
Abstract:
Forty-two patients (forty-four hips) who, at an age of less than forty-five years, had a total hip replacement without cement for the treatment of non-inflammatory osteoarthrosis, were followed for three to seven years (average, four and one-half years). At the latest follow-up evaluation, thirty-seven hips (84 per cent) had an excellent Harris rating; three (7 per cent), good; one (2 per cent), fair; and three (7 per cent), poor. The mean Harris hip score was 92 points, compared with 43 points before the operation. Two hips (5 per cent) had a revision due to complications. In another hip, there was a progressive radiolucent line around the femoral component, increased shedding of beads, and a low score for fixation and stability, according to the criteria of Engh et al. We concluded that total hip arthroplasty without cement, at least for the time-period studied, has a high rate of success for the management of patients less than forty-five years old who have non-inflammatory osteoarthrosis of the hip.