Is the Revision Rate Higher After Hip Arthroplasty in Teenage Patients? A Prospective Study with Long-Term Follow-Up of More Than 10 Years

Vijay C Bose; Kanniyan Kalaivanan; Mithun Manohar; Ashok Kumar; Shantanu Patil; P Suryanarayan

doi:10.1007/s43465-021-00370-0

Is the Revision Rate Higher After Hip Arthroplasty in Teenage Patients? A Prospective Study with Long-Term Follow-Up of More Than 10 Years

Indian J Orthop. 2021 Feb 20;55(4):993-1002. doi: 10.1007/s43465-021-00370-0. eCollection 2021 Aug.

Authors

Vijay C Bose¹, Kanniyan Kalaivanan¹, Mithun Manohar², Ashok Kumar¹, Shantanu Patil³, P Suryanarayan¹

Affiliations

¹ Asian Joint Reconstruction Institute, AJRI @ SIMS Hospitals, Chennai, Tamil Nadu India.
² Gleneagles Global Hospital, Chennai, Tamil Nadu India.
³ SRM Medical College, SRM IST, Kattankulathur, Tamil Nadu India.

Abstract

Background: Total hip arthroplasty (THA) and hip resurfacing arthroplasty (HRA) are already proven good for end-stage arthritis in the older populations but it is challenging in young teenage patients. The primary aim was to assess Hip Disability and Osteoarthritis Outcome Score (HOSS), Harris Hip Score (HHS) and secondary aim for implant survival rate.

Materials and methods: The details of 33 teenage patients (forty hips) who underwent HRA (21) and THA (19) at our institution (January 2002 to December 2013) with a mean follow-up period of 11.00 years (range 7.00-18.40) were included. The study group had 25 males and eight females.

Results: The overall median HOOSs with interquartile range were 89.00 (87.63-0.00). The median HOOSs at follow-up were as follows: 95.00 (90.00-95.00) for symptoms, 92.00 (90.00-95.00) pain, 87.00 (85.00-90.00) for functions, 81.00 (75.00-85.00) for sports and 94.00 (88.00-95.00) for QOL. HHS improved significantly from 36.88 ± 6.14 to 90.12 ± 6.56 (p < 0.001). The HHS of HRA group improved from 36.29 ± 5.83 to 89.38 ± 5.23 and THA group improved from 37.26 ± 6.22 to 90.94 ± 7.84. The 5-year radiological follow-up X-rays did not show any radiolucent line wider than 2 mm in all three zones of the acetabulum and no progressive subsidence or migration of > 1 mm and divergent radiopaque line in femur. The Implant survival rate for HRA was 100% at 5 years, 100% at 10 years, 92% at 15 years and THA group was 100% at 5 years and 90% at 10 years.

Conclusion: Our study showed a disability rate of zero with improved HOSS and HHS. The overall implant survival rate was good with 100% at 5 years, 97% at 10 years and 89.9% at 15 years in contrast to the previous studies with the use of modern implants and newer standard surgical techniques.

Level of evidence: A Level II study http://www.spine.org/Documents/LevelsofEvidenceFinal.pdf.

Keywords: Harris Hip Score (HHS); Hip Disability and Osteoarthritis Outcome Score (HOOS); Hip resurfacing arthroplasty (HRA); Total hip arthroplasty (THA); Young arthroplasty patients.