title: Implant survival and patient-reported outcomes after total hip arthroplasty in young patients with developmental dysplasia of the hip.
abstract: BACKGROUND
  Developmental dysplasia of the hip (DDH) is a common cause of hip pain in young patients, and may require treatment with total hip arthroplasty (THA). This study evaluates implant survival and describes patient-reported outcomes after primary THA in DDH patients aged 35 or younger.
  
  
  METHODS
  A retrospective study with prospective follow-up was conducted at a major academic medical centre. Patient charts were reviewed to identify young THA patients with DDH, and follow-up surveys were conducted to determine implant survival and patient-reported outcomes. Kaplan-Meier survival analysis was performed to evaluate implant survival, and the hip disability and osteoarthritis outcome score (HOOS) was used to describe patient-reported outcomes.
  
  
  RESULTS
  This study included 61 patients (75 THAs, 75% follow-up), and the mean time to follow-up was 13 years (range 3-25 years). The 10-year and 20-year implant survival was 87% (95% CI, 78%-94%) and 55% (95% CI, 37%-72%), respectively, and implant survival was significantly better in patients over the age of 25 at the time of surgery (p value &lt;0.01). The mean HOOS patient scores were 83 for pain (SD 20.29), 78 for symptoms (SD 19.72), 83 for ADLs (SD 20.89), and 74 for sports (SD 25.92). Patients that were younger at the time of surgery or required custom implants reported worse HOOS-Symptom scores at follow-up (p value = 0.02).
  
  
  CONCLUSIONS
  Young patients with DDH have good outcomes after surgery. Patient factors and implant characteristics should be considered when predicting implant survival and outcomes after THA in young patients with DDH.
authors.affiliation: Department of Orthopaedic Surgery, Hospital for Special Surgery, New York - USA.
authors.forename: Ishaan
authors.initials: I
authors.lastname: Swarup
authors.affiliation: Weill Cornell Medical College, New York - USA.
authors.forename: Astrid C
authors.initials: AC
authors.lastname: Marshall
authors.affiliation: Department of Epidemiology and Biostatistics Core, Hospital for Special Surgery, New York - USA.
authors.forename: Yuo-Yu
authors.initials: YY
authors.lastname: Lee
authors.affiliation: Department of Orthopaedic Surgery, Hospital for Special Surgery, New York - USA.
authors.forename: Mark P
authors.initials: MP
authors.lastname: Figgie
mesh_terms: D000328:Adult; D000367:Age Factors; D019644:Arthroplasty, Replacement, Hip; D015331:Cohort Studies; D005260:Female; D006617:Hip Dislocation / Q000601:surgery*; D006622:Hip Prosthesis; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D000071066:Patient Reported Outcome Measures; D011475:Prosthesis Failure; D055815:Young Adult