title: Cemented hip designs are a reasonable option in young patients.
abstract: BACKGROUND
  Young patients with degenerative cartilage disease of the hip remain a challenge for the orthopaedic surgeon. Different treatment options are available of which uncemented hips are the most popular owing to long-term concerns about cemented implants. As an alternative, we have used a cemented hip design in combination with bone impaction grafting in patients with acetabular defects.
  
  
  OBJECTIVE
  We therefore determined the survival rates and radiological failures of cemented THA in patients younger than 30 years and reported clinical scores, complications and current state of the revised THAs.
  
  
  METHODS
  We retrospectively reviewed all 48 patients (69 hips) younger than 30 years at the time of surgery who had a primary cemented THA performed between 1988 and 2004. Acetabular defects were reconstructed using bone impaction grafting in 29 hips. Mean age at surgery was 24.6 years (range, 16-29 years). Revisions were documented, radiographs were analyzed, and the Kaplan-Meier method was used to determine survival for different end points. No patient was lost to followup, three patients (four hips) had died. Minimum followup was 2 years (mean, 8.4 years; range, 2-18 years).
  
  
  RESULTS
  Eight hips were revised (three for infection and five for aseptic loosening) and one hip dislocated for which open reduction was necessary. One additional cup was considered a radiographic failure. The 10-year survival was 83% (95% confidence interval, 69%-92%) with revision for any reason as the end point and 90% (95% confidence interval, 77%-96%) with revision for aseptic loosening.
  
  
  CONCLUSIONS
  We found a high survival rate of these cemented THA in young patients. In young patients with acetabular bone defects we recommend reconstruction using cemented implants with bone impaction grafting.
authors.affiliation: Department of Orthopaedics 357, Radboud University Nijmegen Medical Centre, PO Box 9101, 6500 HB, Nijmegen, The Netherlands.
authors.forename: Vincent
authors.initials: V
authors.lastname: Busch
authors.forename: Rik
authors.initials: R
authors.lastname: Klarenbeek
authors.forename: Tom
authors.initials: T
authors.lastname: Slooff
authors.forename: B Willem
authors.initials: BW
authors.lastname: Schreurs
authors.forename: Jean
authors.initials: J
authors.lastname: Gardeniers
mesh_terms: D000077:Acetabulum / Q000000981:diagnostic imaging / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects / Q000295:instrumentation*; D016025:Bone Transplantation / Q000009:adverse effects; D005260:Female; D006621:Hip Joint / Q000000981:diagnostic imaging / Q000601:surgery*; D006622:Hip Prosthesis; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D009426:Netherlands; D011474:Prosthesis Design; D011475:Prosthesis Failure; D011859:Radiography; D012086:Reoperation; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
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