[Artificial hip replacement in young patients with hip dysplasia--long-term outcome after 10 years].
OBJECTIVE
The experience gained in three decades of hip arthroplasty includes observations on patients with congenital dysplasia of the hip (CDH) under 20 years of age. A study dealing with hip arthroplasty in patients with osteoarthritis following CDH in such young age is not known in the literature. In the present study we report about a long-term follow-up of 41 total hip arthroplasties which were performed using bone-cement in 29 patients from 1966 to 1995.


METHODS
The evaluation of this retrospective study was performed with an questionnaire and a clinical and radiological investigation (Harris hip score, Sutherland activity score).


RESULTS
18 patients with 27 THR (62%) were evaluated clinically and radiologically after a mean duration of follow-up of 10 years and 8 months. Seven additional THR had been revised in the meantime. Kaplan-Meier survival analysis showed a survival rate after 10 years of 64%. Acetabular loosening occurred three times as often as femoral loosening (overall revision rate 41.2%).


CONCLUSIONS
The overall loosening rate of total hip replacement of young patients is significantly elevated. These findings suggest that total hip replacement in young patients with dysplastic hips should be considered most carefully. Implantation of a hip prosthesis is only justified in special cases where alternative procedures are contra-indicated or unacceptable.
Porsch
M
M
Klinik und Poliklinik für Orthopädie, Universität zu Köln.
Siegel
A
A
D000293:Adolescent; D000328:Adult; D019644:Arthroplasty, Replacement, Hip; D019544:Equipment Failure Analysis; D005260:Female; D005500:Follow-Up Studies; D006618:Hip Dislocation, Congenital / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D015207:Osteoarthritis, Hip / Q000000981:diagnostic imaging / Q000601:surgery*; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000601:surgery*; D011474:Prosthesis Design; D011859:Radiography; D012086:Reoperation; D012307:Risk Factors