title: The results of uncemented total hip replacement in children with juvenile idiopathic arthritis at ten years.
abstract: The inherent challenges of total hip replacement   (THR) in children include the choice of implant for the often atypical   anatomical morphology, its fixation to an immature growing skeleton   and the bearing surface employed to achieve a successful long-term   result. We report the medium-term results of 52 consecutive uncemented   THRs undertaken in    35 paediatric patients with juvenile idiopathic arthritis. The mean   age at the time of surgery was 14.4 years (10 to 16). The median   follow-up was 10.5 years (6 to 15). During the study period 13 THRs   underwent revision surgery. With revision as an endpoint, subgroup   analysis revealed 100% survival of the 23 ceramic-on-ceramic THRs   and 55% (16 of 29) of the metal- or ceramic-on-polyethylene. This   resulted in 94% (95% CI 77.8 to 98.4) survivorship of the femoral   component and 62% (95% CI 41.0 to 78.0) of the acetabular component.   Revision of the acetabular component for wear and osteolysis were   the most common reasons for failure accounting for 11 of the 13   revisions. The success seen in patients with a ceramic-on-ceramic articulation   seems to indicate that this implant strategy has the potential to   make a major difference to the long-term outcome in this difficult   group of patients.
authors.affiliation: St George's Healthcare NHS Trust, Blackshaw Road, Tooting, London SW17 0QT, UK. jsdaurka@yahoo.com
authors.forename: J S
authors.initials: JS
authors.lastname: Daurka
authors.forename: A K
authors.initials: AK
authors.lastname: Malik
authors.forename: D A
authors.initials: DA
authors.lastname: Robin
authors.forename: J D
authors.initials: JD
authors.lastname: Witt
mesh_terms: D000077:Acetabulum / Q000601:surgery*; D000293:Adolescent; D001171:Arthritis, Juvenile / Q000601:surgery*; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects / Q000379:methods*; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006621:Hip Joint / Q000601:surgery*; D006622:Hip Prosthesis / Q000009:adverse effects*; D006801:Humans; D008297:Male; D011474:Prosthesis Design / Q000009:adverse effects*; D011475:Prosthesis Failure; D012086:Reoperation; D016019:Survival Analysis; D016896:Treatment Outcome