Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Oct;142(10):2927-2934.
doi: 10.1007/s00402-021-04132-3. Epub 2021 Sep 20.

Is primary total hip arthroplasty in patients with Down's syndrome associated with increased complications at 2 years follow-up?

Nicholas M Hernandez  1 , Daniel J Cunningham  2 , Patrick D Millikan  3 , Colin T Penrose  2 , Thorsten M Seyler  2
Affiliations

Is primary total hip arthroplasty in patients with Down's syndrome associated with increased complications at 2 years follow-up?

Nicholas M Hernandez et al. Arch Orthop Trauma Surg. 2022 Oct.

Abstract

Introduction: Previous reports on primary total hip arthroplasty (THA) in patients with Down's syndrome (DS) are often small and/or lack a comparison cohort, and thus it is challenging to draw meaningful conclusions about this group. The purpose of this study was to report on the post-operative complications in patients with DS undergoing primary THA, compared to a non-DS cohort.

Methods: In this retrospective study, we evaluated patients from 2010 to 2018 using a national database. We assessed surgical complications: closed reduction for dislocation, revision, resection, periprosthetic fracture, and infection in patients with a diagnosis of DS undergoing primary THA and compared them to a THA group of patients without DS. Patients undergoing THA for hip fractures were excluded. Complications were evaluated at 90 days and 2 years. Multivariable logistic regression analysis was used to adjust for age, sex, body mass index, and Charlson comorbidity index.

Results: At 90 days patients with DS had an increased risk of revision (OR 3.1, CI 1.14-8.41), but no significant risk of resection (OR 5.24, CI 0.73-37.8), closed reduction (OR 2.03, CI 0.28-14.59), infection (OR 1.48, CI 0.6-3.62), or periprosthetic fracture (OR 1.97, CI 0.27-14.14). At 2 years patients with DS had an increased risk of periprosthetic fracture (OR 5.88, CI 1.84-18.78), but no significant increased risk of revision (OR 1.82, CI 0.66-5.01), resection (OR 2.37, CI 0.33-17.17), or infection (OR 0.65, CI 0.2-2.07).

Conclusions: Primary THA in patients with DS is associated with increased 90-day revision, and periprosthetic fracture at 2 years.

Keywords: Complications; Down syndrome; Periprosthetic fracture; Revision; Total hip arthroplasty.

PubMed Disclaimer

References

    1. Stoll C, Alembik Y, Dott B, Roth MP (1998) Study of Down syndrome in 238,942 consecutive births. Ann Genet 41:44–51 - PubMed
    1. Huether CA, Ivanovich J, Goodwin BS, Krivchenia EL, Hertzberg VS, Edmonds LD, May DS, Priest JH (1998) Maternal age specific risk rate estimates for Down syndrome among live births in whites and other races from Ohio and metropolitan Atlanta, 1970–1989. J Med Genet 35:482–490. https://doi.org/10.1136/jmg.35.6.482 - DOI - PubMed - PMC
    1. Glasson EJ, Sullivan SG, Hussain R, Petterson BA, Montgomery PD, Bittles AH (2002) The changing survival profile of people with Down’s syndrome: implications for genetic counselling. Clin Genet 62:390–393. https://doi.org/10.1034/j.1399-0004.2002.620506.x - DOI - PubMed
    1. Kriss VM (1999) Down syndrome: imaging of multiorgan involvement. Clin Pediatr (Phila) 38:441–449. https://doi.org/10.1177/000992289903800801 - DOI
    1. Bennet GC, Rang M, Roye DP, Aprin H (1982) Dislocation of the hip in trisomy 21. J Bone Jt Surg Br 64:289–294 - DOI

MeSH terms

LinkOut - more resources