title: Long-term results of cemented total hip arthroplasty in patients younger than 30 years and the outcome of subsequent revisions.
abstract: BACKGROUND
  The number of total hip arthroplasties in patients under 30 years is increasing over the years. Almost all of them will face at least one or more future revisions in their life. Therefore, the implant used should have a high survival rate, and needs to be easily revisable resulting in a low re-revision rate. Several studies have evaluated the outcome of total hip arthroplasties in patients under 30 years. However, only a few reported on the follow-up outcome of 10 years or more. In addition, none of these reports published data of the subsequent revisions of these implants within their original report.
  
  
  METHODS
  We studied historically prospective collected data of 48 consecutive patients (69 hips) younger than 30 years, treated with a cemented primary total hip prosthesis between 1988 and 2004. Since the last evaluation of this cohort, two patients were lost to follow-up. For all hip revisions in this cohort, again cemented implants were used, mostly in combination with bone impaction grafting. Kaplan-Meier survival curves at 10- and 15 years for the primary total hip arthroplasties and revisions were determined.
  
  
  RESULTS
  The mean age at time of primary surgery was 25 years (range, 16 to 29 years). Mean follow-up of the primary hips was 11.5 years (range, 7 to 23 years). During follow-up 13 revisions were performed; in 3 cases a two-stage total revision was performed for septic loosening and 9 cups were revised for aseptic loosening. There were no aseptic stem revisions. The 10 and 15-year survival rates with endpoint revision for aseptic loosening of the primary total hip were 90% (95% CI: 79 to 96) and 82% (95% CI: 65 to 92) respectively. None of our 13 subsequent revisions needed a re-revision within 10 years after re-implantation.
  
  
  CONCLUSIONS
  Cemented total hip implants in patients under 30 years have an encouraging outcome at 10 and 15 years after surgery in these young patients. The 13 revised hips, treated with bone grafting and the third generation cement technique, were performing well with no re-revisions within ten years after surgery.
authors: Department of Orthopaedics, Radboud University Nijmegen Medical Centre, Internal Post 357, PO Box 9101, Nijmegen, HB 6500, The Netherlands.
authors: Marloes W J L
authors: MW
authors: Schmitz
authors: Vincent J J F
authors: VJ
authors: Busch
authors: Jean W M
authors: JW
authors: Gardeniers
authors: Jan C M
authors: JC
authors: Hendriks
authors: René P H
authors: RP
authors: Veth
authors: B Willem
authors: BW
authors: Schreurs
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects / Q000295:instrumentation; D001696:Biomechanical Phenomena; D001843:Bone Cements / Q000009:adverse effects / Q000627:therapeutic use*; D016025:Bone Transplantation; D005260:Female; D006621:Hip Joint / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D006622:Hip Prosthesis; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000601:surgery; D011446:Prospective Studies; D011474:Prosthesis Design; D011475:Prosthesis Failure; D011859:Radiography; D020127:Recovery of Function; D012086:Reoperation; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D001843:Bone Cements