Total hip arthroplasty in 40 years old patients or younger in comparison with the old ones

ABSTRACT

The results of total hip arthroplasty in young adults indicate a high complication rate and questionable durability. We set up this study to evaluate our experience in the mentioned topic. In a retrospective study, we evaluate 239 hips which have been undergone THA since 1983 in our hospital. We invite them for current set of clinical and radiological evaluation. Ninety Six of them responded and came for follow up. Then the Harris hip score and status of implant were compared. The mean age at the time of follow-up was 33.1 +/- 7.6 in younger group and 67 +/- 13.6 in older group. The mean Harris score, survival of cup and survival of stem was 79.8 +/- 14.6, 4 +/- 2.6 and 4.26 +/- 3 in young patients and 77.5 +/- 16.2, 5.2 +/- 3.7 and 5.3 +/- 3.6 in older patients respectively [P<0.55, P<0.06, and P<0.10 respectively]. Multivariable analysis shows significant effect of age and duration of follow up [P<0.039] on overall implant loosening which indicate the confounder role of follow up period. We match the following up period between the groups. Analysis of cemented THA shows mean Harris score of 88 +/- 4 in younger and 8.12 +/- 11.7 in older group [P<0.27], 0% cup loosening of younger and 9.5% of older group [P<0.52] and 25% stem loosening of younger and 9.5% of the older group [P<0.38]. Analysis of cement less THA showed mean Harris score of 76.5 +/- 15.9 in younger and 80.2 +/- 14.5 in older group [P<0.05, r-0.295] and 0% stem loosening of younger and 4% of older group [P<0.46]. The major draw back of our study was lower cementless cup survival in younger patients. Anyway, the new implant design and technique seems to improve durability of implant in younger adult but not enough to reject the concept of poor survival of THA in younger patients