title: Functional outcomes of total hip arthroplasty in patients aged 30 years or less: a systematic review and meta-analysis.
abstract: BACKGROUND
  Young adult hip surgery is a growing subspecialty. Increasingly total hip arthroplasty (THA) is offered to patients aged 30 or less suffering from end-stage hip arthropathy from a variety of congenital, developmental and acquired conditions. There is a paucity of evidence to advise such patients and surgeons alike on the functional outcomes of THA in this age group, as individual studies tend to include small cohorts.
  
  
  METHODS
  A systematic review and meta-analysis was performed to assess whether THA in patients aged 30 years or less provides significant functional improvement. The primary outcome measure was change in Harris Hip Score. Secondary outcome measures were implant survivorship and the effect of fixation type and bearing surface.
  
  
  RESULTS
  The results of 743 primary THA procedures were included. Weighted mean patient age was 22.7 years. Harris Hip Score improved by a weighted mean difference of 42.17 points out of 100 (95% confidence interval, 36.48-47.86 points, p&lt;0.001) after THA at a weighted mean follow-up of 8.4 years. Pooled revision rate was 5.0% for the same time period.
  
  
  CONCLUSIONS
  This is the largest review to date of THA in patients aged 30 or less. The results show significant functional improvement measured by Harris Hip Score. The revision rate of 5% at 8.4 years is comparable to the general THA population. This contrasts high revision rates reported in older reviews of the literature, suggesting adoption of improved techniques and implants in the more recent literature.
authors.affiliation:  Department of Orthopaedics, Guy's and St Thomas' NHS Foundation Trust, London - UK.
authors.forename: Roland P
authors.initials: RP
authors.lastname: Walker
authors.affiliation:  Department of Orthopaedics and Trauma, King's College Hospital, London - UK.
authors.forename: Matthew
authors.initials: M
authors.lastname: Gee
authors.affiliation:  Department of Orthopaedics, Guy's and St Thomas' NHS Foundation Trust, London - UK.
authors.forename: Fabian
authors.initials: F
authors.lastname: Wong
authors.affiliation:  Department of Orthopaedics, Guy's and St Thomas' NHS Foundation Trust, London - UK.
authors.forename: Zameer
authors.initials: Z
authors.lastname: Shah
authors.affiliation:  Department of Orthopaedics, Guy's and St Thomas' NHS Foundation Trust, London - UK.
authors.forename: Marc
authors.initials: M
authors.lastname: George
authors.affiliation:  Department of Orthopaedics, Guy's and St Thomas' NHS Foundation Trust, London - UK.
authors.forename: Marcus J K
authors.initials: MJ
authors.lastname: Bankes
authors.affiliation:  Department of Orthopaedics, Guy's and St Thomas' NHS Foundation Trust, London - UK.
authors.forename: Adil
authors.initials: A
authors.lastname: Ajuied
mesh_terms: D000328:Adult; D019644:Arthroplasty, Replacement, Hip; D006801:Humans; D012086:Reoperation; D016896:Treatment Outcome; D055815:Young Adult