Risk Factors for Revision of Hip Arthroplasties in Patients Younger Than 30 Years

Overview

Journal Clin Orthop Relat Res

Publisher Wolters Kluwer

Specialty Orthopedics

Date 2010 Nov 19

PMID 21086195

Citations 24

Authors

Julien Girard

Christophe Glorion

Francois Bonnomet

Damien Fron

Henri Migaud

Affiliations

Soon will be listed here.

Abstract

Background: Numerous reports of THAs in patients younger than 30 years indicate a high risk of revision. Although risk factors for revision have been reported for older patients, it is unclear whether these risk factors are the same as those for patients younger than 30 years.

Questions/purposes: We therefore (1) determined function and survivorship of revision THAs performed in patients younger than 30 years, and (2) assessed the risk factors for revision THAs in this younger population by comparison with a group of patients younger than 30 years who did not undergo revision.

Patients And Methods: We retrospectively reviewed the clinical records and radiographs of 55 patients younger than 30 years (average age at revision, 24.3 years; range, 14-30 years) who underwent 77 hip revisions. Revision was performed, on average, 4.6 years (range, 0.4-12 years) after the primary THA. The results for these 55 patients (77 revision THAs) were compared with results for a nonrevised group, including 819 THAs in patients younger than 30 years. Minimum followup of the revision group was 1 year (mean, 6.2 years; range, 1-15 years).

Results: At followup after the revision, the Merle d'Aubigné-Postel score improved from 12.2 to 14.6. The rates of dislocation, neurologic lesions, and fractures were 15%, 7.8%, and 14%, respectively. The 10-year survival rate was 36% (95% confidence interval [CI], 21%-51%). Compared with the nonrevised group, the independent revision risk factors were young age at primary THA (OR 1.14 [1.07-1.19]), high number of previous surgeries (OR 5.41 [2.67-10.98]), and occurrence of at least one dislocation (OR 3.98 [1.74-9.07]). Hard-on-soft bearings had a higher risk (OR 3.42 [1.91-6.1]) of revision compared with hard-on-hard bearings.

Conclusions: Revision THAs are likely in patients younger than 30 years, and the complication rate is high. The survivorship of hip revision in this population is low and alternative solutions should be advocated whenever possible.

Level Of Evidence: Level III, therapeutic study, case control study. See the Guidelines for Authors for a complete description of levels of evidence.

Citing Articles

Challenges and Long-Term Outcomes of Cementless Total Hip Arthroplasty in Patients Under 30: A 24-Year Follow-Up Study with a Minimum 8-Year Follow-Up, Focused on Developmental Dysplasia of the Hip.

Drobniewski M, Gonera B, Olewnik L, Borowski A, Ruzik K, Triantafyllou G J Clin Med. 2024; 13(21).

PMID: 39518730 PMC: 11546925. DOI: 10.3390/jcm13216591.

Pediatric hip disorders are not associated with an increased 10-year revision risk after total hip arthroplasty under the age of 55: results from the Dutch Arthroplasty Register.

Bus M, Gademan M, Fiocco M, Nelissen R, de Witte P Acta Orthop. 2024; 95:472-476.

PMID: 39192775 PMC: 11350965. DOI: 10.2340/17453674.2024.41342.

Comparison of dynamic compression system versus multiple cancellous screws in the treatment of femoral neck fractures in young adults.

Aljasim O, Yener C, Ozkayin N J Orthop Surg Res. 2024; 19(1):422.

PMID: 39039508 PMC: 11265074. DOI: 10.1186/s13018-024-04913-7.

Early Postoperative Weight-Bearing Ability after Total Hip Arthroplasty versus Bipolar Hemiarthroplasty in Elderly Patients with Femoral Neck Fracture.

Grabmann C, Hussain I, Zeller A, Kirnaz S, Sullivan V, Sommer F J Clin Med. 2024; 13(11).

PMID: 38892839 PMC: 11172539. DOI: 10.3390/jcm13113128.

What has changed in total hip arthroplasty in patients of juvenile idiopathic arthritis since 2000? A systematic review and pooled data analysis.

Barik S, Jain A, Chanakya P, Raj V, Goyal T Eur J Orthop Surg Traumatol. 2023; 33(7):2737-2748.

PMID: 36947313 DOI: 10.1007/s00590-023-03525-x.

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