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Minerva Ortopedica e Traumatologica 2018 December;69(4):99-106

DOI: 10.23736/S0394-3410.18.03894-8


lingua: Inglese

Clinical and radiographic outcomes of total hip replacements in patients aged under 25 years

Nicola RATTO 1, Alessandra CIPOLLA 2, Simone DE VIVO 3, Michele BOFFANO 1, Alessandro APRATO 3 , Raimondo PIANA 1, Alessandro MASSÉ 3

1 Division of Orthopedic Oncology, Città della Salute e della Scienza di Torino, Turin, Italy; 2 University of Turin, Turin, Italy; 3 Division of Orthopedics and Traumatology, Città della Salute e della Scienza di Torino, Turin, Italy

BACKGROUND: The number of total hip replacement (THR) is expected to increase specially in younger patients who suffer severe joint diseases. Several conditions may cause early osteoarthritis in young patients: the most frequent disorder is femoral head osteonecrosis in patients treated for acute lymphoblastic leukemia. The osteonecrosis determines a marked reduction in function and mobility due to articular degeneration and pain. Few studies have reported long-term results about implants in patients younger than 25 years of age. The purposes of this study are to: 1) evaluate life quality from a subjective point of view; 2) objectively examine clinical functionality; 3) carry out a radiographic evaluation of prosthesis integration in a group of patients under 25 who underwent a THR.
METHODS: We have retrospectively evaluated 33 uncemented THRs implanted in 25 patients younger than 25 years. The clinical outcome was measured using Harris Hip Score (HHS). Life quality was measured using SF36 and EQ-5D-5L. Radiographic controls were also examined to highlight signs of loosening or osteolysis.
RESULTS: The mean age at surgery was 19.2 years old. To an average follow-up of four years, the mean score of HHS at the final follow-up was 90±17.9. The mean PCS-SF36 was 46.8±10.8 and MCS-SF36 was 42.8±16.7. The mean EQ-5D-5L result was 0.85±0.19. Three complications occurred: an intraoperative femoral fracture, a case of asymptomatic heterotopic ossification and an aseptic loosening. In all other patients the implants were stable without any sign of loosening or significant radiolucent lines.
CONCLUSIONS: Our study suggests that the quality of life and functionality significantly improved in most of these young patients who underwent THR, therefore we believe that THR is a reasonable surgical option in adolescence and early adulthood for selected patients who suffer from severe disability and hip joint diseases.

KEY WORDS: Precursor cell lymphoblastic leukemia-lymphoma - Hip osteoarthritis - Osteonecrosis Femur head - Hip replacement arthroplasty

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