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. 2010 Apr;81(2):165-70.
doi: 10.3109/17453671003717831.

Good results with cemented total hip arthroplasty in patients between 40 and 50 years of age

Daniël C J de Kam  1 , Jean W M Gardeniers, René P H Veth, B Willem Schreurs
Affiliations

Good results with cemented total hip arthroplasty in patients between 40 and 50 years of age

Daniël C J de Kam et al. Acta Orthop. 2010 Apr.

Abstract

Background and purpose: Total hip arthroplasties in young patients have lower long-term survival rates than in older patients. We evaluated the use of a unique treatment protocol in patients aged between 40 and 50 years. In all cases we used a cemented THA, and for acetabular deficiencies we also used impacted bone grafts together with a cemented cup.

Methods: In 140 consecutive patients who were between 40 and 50 years of age at index surgery, 168 cemented total hip prostheses were evaluated after a mean follow-up time of 10 (2-19) years. Acetabular deficiencies were reconstructed with wire meshes and impacted bone grafts with a cemented cup (70 hips). During follow-up, 18 patients died (27 hips); in this group 3 hips (3 patients) had been revised. None of the patients were lost to follow-up. In all surviving patients, clinical assessment was performed with hip-score questions and all radiographs were evaluated.

Results: All clinical questionnaires showed an improved clinical hip score. 29 hips (17%) were revised after a mean of 8 (0.3-18) years. Kaplan-Meier survival analysis showed a survival of 88% (95% CI: 82-94) after 10 years with revision of either component for any reason. Survival with endpoint revision for aseptic loosening of either component was 94% (95% CI: 90-99) after 10 years.

Interpretation: Cemented implants in young patients have satisfying long-term results. Reconstruction of acetabular deficiencies with impacted bone grafts show promising results.

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Figures

Figure 1.
Figure 1.
A 43-year-old female with developmental dysplasia of the hips with high dislocation. A. Preoperatively. B. Directly postoperatively after primary THA with distalization and reconstruction of the cup to its anatomical center of rotation giving a neurological deficit. C. Postoperatively after cup revision 2 years later with cranialization of the cup. D. 12 years after cup revision.
Figure 2.
Figure 2.
Kaplan-Meier survival curve with endpoint revision for aseptic loosening of any component (95% confidence intervals in broken lines).
See this image and copyright information in PMC

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