title: Total hip replacement in patients with Down syndrome and degenerative osteoarthritis of the hip.
abstract: Dysplasia of the hip, hypotonia, osteopenia, ligamentous laxity, and mental retardation increase the complexity of performing and managing patients with Down syndrome who require total hip replacement (THR). We identified 14 patients (six males, eight females, 21 hips) with Down syndrome and degenerative disease of the hip who underwent THR, with a minimum follow-up of two years from 1969 to 2009. In seven patients, bilateral THRs were performed while the rest had unilateral THRs. The mean clinical follow-up was 5.8 years (standard deviation (sd) 4.7; 2 to 17). The mean Harris hip score was 37.9 points (sd 7.8) pre-operatively and increased to 89.2 (sd 12.3) at final follow-up (p = 1x10(-9)). No patient suffered a post-operative dislocation. In three patients, four hips had revision THR for aseptic loosening at a mean follow-up of 7.7 years (sd 6.3; 3 to 17). This rate of revision THR was higher than expected. Our patients with Down syndrome benefitted clinically from THR at mid-term follow-up.
authors.affiliation: Stanford University, 450 Broadway Street, Redwood City, California, 94063, USA.
authors.forename: D F
authors.initials: DF
authors.lastname: Amanatullah
authors.affiliation: University of Buffalo, 100 High Street, Buffalo, New York 14203, USA.
authors.forename: S R
authors.initials: SR
authors.lastname: Rachala
authors.affiliation: Mayo Clinic, 200 First Street SW, Rochester, Minnesota, 55905, USA.
authors.forename: R T
authors.initials: RT
authors.lastname: Trousdale
authors.affiliation: Mayo Clinic, 200 First Street SW, Rochester, Minnesota, 55905, USA.
authors.forename: R J
authors.initials: RJ
authors.lastname: Sierra
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000379:methods*; D004314:Down Syndrome / Q000150:complications*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015207:Osteoarthritis, Hip / Q000150:complications / Q000601:surgery*; D011446:Prospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
keywords: Hip arthroplasty; Hip dysplasia; Down syndrome; Arthritis