title: Mid-to long-term results of revision total hip replacement in patients aged 50 years or younger.
abstract: Revision total hip replacement (THR) for young patients is challenging because of technical complexity and the potential need for subsequent further revisions. We have assessed the survivorship, functional outcome and complications of this procedure in patients aged < 50 years through a large longitudinal series with consistent treatment algorithms. Of 132 consecutive patients (181 hips) who underwent revision THR, 102 patients (151 hips) with a mean age of 43 years (22 to 50) were reviewed at a mean follow-up of 11 years (2 to 26) post-operatively. We attempted to restore bone stock with allograft where indicated. Using further revision for any reason as an end point, the survival of the acetabular component was 71% (sd 4) and 54% (sd 7) at ten- and 20 years. The survival of the femoral component was 80% (sd 4) and 62% (sd 6) at ten- and 20 years. Complications included 11 dislocations (6.1%), ten periprosthetic fractures (5.5%), two deep infections (1.1%), four sciatic nerve palsies (2.2%; three resolved without intervention, one improved after exploration and freeing from adhesions) and one vascular injury (0.6%). The mean modified Harris Hip Score was 41 (10 to 82) pre-operatively, 77 (39 to 93) one year post-operatively and 77 (38 to 93) at the latest review. This overall perspective on the mid- to long-term results is valuable when advising young patients on the prospects of revision surgery at the time of primary replacement.
authors.affiliation: Royal London Hospital, Barts Health NHS Trust. Whitechapel Rd, London, E1 1BB, UK.
authors.forename: P T H
authors.initials: PT
authors.lastname: Lee
authors.affiliation: E. Wolfson Medical Center, Holon, Israel.
authors.forename: D L
authors.initials: DL
authors.lastname: Lakstein
authors.affiliation: Hospital San Felipe de Jesus, Paseo de los Leones #2508, Col. Cumbres her Sector, Monterey, N.L. 64610, México.
authors.forename: B
authors.initials: B
authors.lastname: Lozano
authors.affiliation: Mount Sinai Hospital, Division of Orthopaedic Surgery, 600 University Avenue, Toronto, Ontario M5G 1X5, Canada.
authors.forename: O
authors.initials: O
authors.lastname: Safir
authors.affiliation: Mount Sinai Hospital, Division of Orthopaedic Surgery, 600 University Avenue, Toronto, Ontario M5G 1X5, Canada.
authors.forename: J
authors.initials: J
authors.lastname: Backstein
authors.affiliation: Mount Sinai Hospital, Division of Orthopaedic Surgery, 600 University Avenue, Toronto, Ontario M5G 1X5, Canada.
authors.forename: A E
authors.initials: AE
authors.lastname: Gross
mesh_terms: D000328:Adult; D000367:Age Factors; D019644:Arthroplasty, Replacement, Hip / Q000706:statistics & numerical data*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control; D011475:Prosthesis Failure; D012086:Reoperation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
keywords: Arthroplasty; Hip; Replacement; Revision; Young