Cementless ceramic hip arthroplasties in patients less than 30 years old

Twenty-six cementless ceramic hip arthroplasties were performed in 22 patients with an average age of 24 years (range, 17-30 years) at the time of operation. One patient was lost to follow-up evaluation. Twenty-one patients (25 hips) were reviewed with an average follow-up period of 6.5 years (range, 4-13 years). Two hips had to undergo revision of the ceramic acetabular components because of fractures in the upper part of the cup in both. One further hip was explored because of persistent wound discharge, but a mass of indurated tissue was removed and there was no evidence of deep infection. No organisms were grown from the samples taken during operation. Harris hip scores were good to excellent in 64%, fair in 16%, and poor in 20% of cases. There was no or slight pain in 14 (56%), mild pain in 7 (28%), and moderate pain in 4 (16%) hips. Apart from the two sockets revised, progressive radiolucent lines were seen in five cups (20%) and significant vertical migration was present in nine cups (36%) with an average migration of 1.3 mm/y. In total, acetabular changes were observed in 11 cases (44%). Femoral stem subsidence of between 3 and 6 mm was seen in five cases (20%). The total number of hips showing loosening of one or both components was five (20%). Overall radiographic changes (migration and loosening) in one or both components were present in 13 hips (54%).