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

• Published in: Acta orthopaedica Vol. 81; no. 2; pp. 165 - 170
• Main Authors: de Kam, Daniël C J, Gardeniers, Jean W M, Veth, René P H, Schreurs, B Willem
• Format: Journal Article
• Language: English
• Published: England Informa UK Ltd 01.04.2010
• Subjects: Adult; Arthroplasty, Replacement, Hip - adverse effects; Arthroplasty, Replacement, Hip - methods; Cementation; Female; Follow-Up Studies; Hip Joint - diagnostic imaging; Hip Prosthesis - adverse effects; Humans; Male; Middle Aged; Prosthesis Design; Prosthesis Failure; Radiography; Reoperation; Surveys and Questionnaires; Treatment Outcome
• ISSN: 1745-3674; 1745-3682
• DOI: 10.3109/17453671003717831

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.