Abstract

BACKGROUND
THA in patients younger than 30 years presents challenges because of uncertainties regarding the long-term survivorship of prostheses. Alumina-on-alumina bearings, which exhibit little long-term wear, may be a reasonable option but the long-term survivorship is unknown.
QUESTIONS/PURPOSES
We determined (1) the survival rate of alumina-on-alumina bearings in patients younger than 30 years after a 10-year followup, (2) the incidence of audible hip clicking and squeaking, (3) radiographic evidence of osteolysis, and (4) the effects on pregnancy, childbirth, and career choice.
METHODS
We retrospectively reviewed 62 patients who had 75 THAs with alumina-on-alumina bearings followed more than 10 years (average, 11.5; range, 10-13.5 years). Mean patient age at the time of surgery was 24 years (range, 18-30 years). All operations were performed using the same cementless implant at a single center. We determined survival, presence of osteolysis, and function (Harris hip score, WOMAC).
RESULTS
The 10-year survival rate of alumina-on-alumina bearings in THAs, with revision for any reason as the end point, was 98.9%. Audible hip clicking and squeaking were identified in 10 hips and two hips, respectively. No osteolysis was detected. None of the 11 patients who became pregnant had been affected by their THA during pregnancy or childbirth. Seven of the 14 patients who were unemployed at the time of index surgery stated that their THA affected their job choice.
CONCLUSIONS
We found a high 10-year survival of cementless alumina-on-alumina bearings in THAs in patients younger than 30 years. Lifetime events such as job choice, pregnancy, and childbirth should be considered when choosing THA for patients younger than 30 years.
LEVEL OF EVIDENCE
Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

Links

Publisher Full Text

Publisher Full Text

Authors

Yoon HJ, Yoo JJ, Yoon KS, Koo KH, Kim HJ

Institution

Department of Orthopedic Surgery, Seoul National University Hospital, Seoul, South Korea.

Source

Clinical orthopaedics and related research 470:12 2012 Dec pg 3530-6

MeSH

Adolescent
Adult
Age Factors
Aluminum Oxide
Arthroplasty, Replacement, Hip
Biomechanics
Career Choice
Female
Follow-Up Studies
Hip Joint
Hip Prosthesis
Humans
Joint Diseases
Kaplan-Meier Estimate
Male
Noise
Osteolysis
Parturition
Pregnancy
Prosthesis Design
Prosthesis Failure
Recovery of Function
Retrospective Studies
Time Factors
Treatment Outcome
Young Adult

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

22826015