title: Advantages in Using Cemented Polished Tapered Stems When Performing Total Hip Arthroplasty in Very Young Patients.
abstract: The risk of revision following primary total hip arthroplasty (THA) is increased in young patients who undergo THA for pathologies other than primary osteoarthritis. We report the results of primary THA performed with cemented polished stems in patients aged 40 years and younger for pathologies other than primary osteoarthritis.
  
  
  
  We investigated 52 patients (65 hips) who underwent primary THA for secondary osteoarthritis with a cemented tapered polished stem between 1990 and 2007. Clinical and radiographic outcomes, available in 46 patients (57 hips), included the Harris Hip Scores, Societe Internationale de Chirurgie Orthopedique et de Traumatologie activity, patient satisfaction, stem survival and reoperations, and assessment of prosthesis-cement-bone radiolucencies, osteolysis, and femoral bone deficiencies.
  
  
  
  Median patient age was 34 years (16-40) and follow-up was 14 years (mean 13, range 5-22). Stem survival to the endpoint revision for loosening was 100% and to the endpoint revision for any reason, excluding infection was 88% (95% confidence interval 78-98) at 16 years. No stem was revised for aseptic loosening. Nine stems were revised for other reasons. Radiographically, one stem was definitely loose at 16 years. The median patient Harris pain score improved from marked pain to no pain at latest follow-up. Patient activity level improved, albeit minimally, for 8 years after surgery. At latest follow-up, 98% of the patients remained satisfied with their surgery.
  
  
  
  Primary THA with a cemented polished stem shows excellent results in young patients with pathology other than primary osteoarthritis. In addition, the stem design facilitates cement within cement exchange and therefore preservation of proximal femoral bone stock at revision surgery.
authors.affiliation: Department of Orthopaedics and Trauma, Royal Adelaide Hospital, Adelaide, South Australia, Australia.
authors.forename: Kerry
authors.initials: K
authors.lastname: Costi
authors.affiliation: Department of Orthopaedics and Trauma, Royal Adelaide Hospital and Discipline of Orthopaedics and Trauma, The University of Adelaide, Royal Adelaide Hospital, Adelaide, South Australia, Australia.
authors.forename: Lucian B
authors.initials: LB
authors.lastname: Solomon
authors.affiliation: Department of Orthopaedics and Trauma, Royal Adelaide Hospital, Adelaide, South Australia, Australia.
authors.forename: Margaret A
authors.initials: MA
authors.lastname: McGee
authors.affiliation: Department of Orthopaedics and Trauma, Royal Adelaide Hospital and Discipline of Orthopaedics and Trauma, The University of Adelaide, Royal Adelaide Hospital, Adelaide, South Australia, Australia.
authors.forename: Mark S
authors.initials: MS
authors.lastname: Rickman
authors.affiliation: Department of Orthopaedics and Trauma, Royal Adelaide Hospital and Discipline of Orthopaedics and Trauma, The University of Adelaide, Royal Adelaide Hospital, Adelaide, South Australia, Australia.
authors.forename: Donald W
authors.initials: DW
authors.lastname: Howie
mesh_terms: D000293:Adolescent; D000328:Adult; D019644:Arthroplasty, Replacement, Hip / Q000295:instrumentation*; D001843:Bone Cements; D005260:Female; D005269:Femur; D005500:Follow-Up Studies; D006622:Hip Prosthesis / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D010146:Pain / Q000209:etiology; D017060:Patient Satisfaction; D010549:Personal Satisfaction; D011474:Prosthesis Design; D011859:Radiography; D012086:Reoperation; D055815:Young Adult
chemical_list: D001843:Bone Cements
keywords: cemented; outcomes; polished tapered stems; primary hip arthroplasty; young patients