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. 2024 Dec;110(8):103978.
doi: 10.1016/j.otsr.2024.103978. Epub 2024 Aug 26.

Mid to long-term survivorship of hip arthroplasty in patients 40 years and younger

Camille Vorimore  1 , Andrew Adamczyk  2 , Pierre Laboudie  3 , Marc Antoine Ricard  1 , Paul E Beaule  1 , George Grammatopoulos  4
Affiliations

Mid to long-term survivorship of hip arthroplasty in patients 40 years and younger

Camille Vorimore et al. Orthop Traumatol Surg Res. 2024 Dec.

Abstract

Background: Etiology of hip osteoarthritis (OA) and survival of hip arthroplasty in the young (below 40-years-old) remains poorly described. Furthermore, joint survivorship mid to long-term and PROMs according to the etiology are unclear. The study aims were to 1) identify the indications for arthroplasty in the below 40-years-old cohort; 2) define hip arthroplasty outcomes in the young and 3) test whether patients with sequelae of pediatrics hip disease have inferior outcome compared to other patients.

Hypothesis: Our hypothesis was that hip arthroplasty is a viable option for managing hip disease in patients under 40, with excellent survival rates and outcomes.

Material and methods: This is an IRB approved, retrospective, consecutive, multi-surgeon, cohort study from a single academic center. Indication for hip arthroplasty of 346 patients (410 hips) below 40-years-old were studied; 239 underwent THA (58%) and 171 hip resurfacing (42%). Patient, surgical and implant factors were tested for association with implant survivorship and functional outcome for hip arthroplasty performed with a follow-up of more than two years. Pediatric hip sequelae patients were compared for survival and PROMs with the rest of the cohort.

Results: The most common etiology of OA was FAI (47%), followed by pediatric hip sequelae (18%). The 10-year survivorship was 97.2% ± 1.2, mean OHS was 45.1 ± 6.3 and mean HHS was 93.4 ± 12.6. The pediatric hip sequelae subgroup demonstrated no differences in 10-year survivorship and better PROMs compared to rest (OHS: 46.6 ± 3.8; HHS: 96.0 ± 8.5).

Discussion: The most common aetiologies amongst the young with hip OA is FAI and pediatric hip sequelae. Hip arthroplasty in the young presents excellent 10-year survivorship and PROMs. Excellent survival and PROMs in the young with pediatric hip sequelae provide important information for decision-making in this challenging population.

Level of evidence: III; retrospective cohort study.

Keywords: Etiology; Hip resurfacing; Osteoarthritis; Outcomes; Pediatric hip sequelae; Survivorship; Total hip arthroplasty; Young.

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