title: Total hip arthroplasty in teenagers: an alternative to hip arthrodesis.
abstract: Debilitating arthritis in teenage patients is a complex problem with limited surgical options. Hip arthrodesis is unpopular amongst patients, and contemporary total hip arthroplasty (THA) may be a promising alternative. We report on the outcomes of THA in patients less than 20 years of age. All consecutive teenage patients undergoing THA at a tertiary referral centre were reviewed. Mean follow-up was 3.4 years (range 0.6-6.8) and 9 patients had at least 5 years follow-up. There were 51 THAs in 43 patients with a mean age of 17 years (range 12-19). The commonest indication was osteonecrosis (35 cases), mostly secondary to slipped upper femoral epiphysis (15 cases). Forty-six were uncemented and 5 were reverse hybrid THAs of which 7 were computer assisted design/manufacture (CADCAM) components. The commonest bearing surface used was ceramic on ceramic (40 cases). The survival rate was 96% and there were 2 complications. At latest follow-up, the mean Harris hip score was 90 (range 68-99) and UCLA activity score was 6 (range 4-9). Radiological analysis showed 2 patients with lucent lines around the acetabular component, but no signs of osteolysis or wear. We report good short to intermediate term survivorship and outcomes, and feel THA represents a valid alternative option to hip arthrodesis.
authors.affiliation: The Catterall Unit, Royal National Orthopaedic Hospital, Stanmore, Middlesex, UK. niravpatel@doctors.org.uk
authors.forename: Nirav K
authors.initials: NK
authors.lastname: Patel
authors.forename: Thomas
authors.initials: T
authors.lastname: Luff
authors.forename: Paul
authors.initials: P
authors.lastname: Whittingham-Jones
authors.forename: Christopher R
authors.initials: CR
authors.lastname: Gooding
authors.forename: Aresh
authors.initials: A
authors.lastname: Hashemi-Nejad
mesh_terms: D000293:Adolescent; D001174:Arthrodesis; D019644:Arthroplasty, Replacement, Hip; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D015207:Osteoarthritis, Hip / Q000601:surgery*; D055815:Young Adult