Cementless Hip Arthroplasty in Juvenile Idiopathic Arthritis

Odent, Thierry; Journeau, Pierre; Prieur, Anne‐Marie; Touzet, P; Jc, Pouliquen; Glorion, Christophe

doi:10.1097/01.bpo.0000161096.53963.0e

Cited by 58 publications

(48 citation statements)

References 19 publications

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“…The survivorship of cementless primary THA in patients with JIA was reported to be 96% to 100% for the femoral stem and 88% to 90% for the acetabular cup at 5 to 13 years followup [20,21,30]. Thus, reoperations and revision procedures in this challenging, young patient population is relatively common, a finding we confirmed.…”

Section: Discussionsupporting

confidence: 69%

High Complication Rate in Revision Total Hip Arthroplasty in Juvenile Idiopathic Arthritis

Goodman¹,

Hwang²,

Imrie³

2013

Clin Orthop Relat Res

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Background Revision total hip arthroplasty (THA) in patients with juvenile idiopathic arthritis (JIA) is challenging as a result of the patient's young age, systemic disease, multiple affected joints, small proportions, and bone loss. The intermediate-to long-term results of these surgeries remain unknown. Questions/purposes The purpose of this study is to determine the (1) functional outcomes; (2) surgical complications; and (3) frequency of reoperation or revision after revision THA for JIA. Methods We reviewed the records of all patients from one center who underwent revision THA for JIA who had a minimum of 5 years of followup (mean, 9 years; range, 5-19 years). This resulted in a series of 24 revision THAs in 15 patients. All patients were Charnley Class C. Age at revision averaged 35 years (range, 21-53 years). The 20 acetabular and 12 femoral revision components included 15 cementless cups, five reconstruction/roof rings with a cemented cup, and four cemented and eight cementless femoral stems. Results The Harris hip scores improved from 54 (range, 34-85) to 77 (range, 37-100) (p \ 0.001). Complications included two proximal femoral fractures associated with severe osteolysis and one sciatic nerve palsy in a patient with severe acetabular deficiency. A total of seven hips (29%) required reoperation or revision surgery, including three for infection (one early and two late) and four for mechanical loosening. Conclusions Revision THA in JIA is very challenging owing to patients' small proportions and compromised bone stock. The intraoperative and early complication rates are relatively high. Prognosis for long-term survivorship is guarded; limiting factors include periprosthetic osteolysis associated with older implants that used conventional polyethylene and cemented stems.

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Section: Discussionsupporting

confidence: 69%

High Complication Rate in Revision Total Hip Arthroplasty in Juvenile Idiopathic Arthritis

Goodman¹,

Hwang²,

Imrie³

2013

Clin Orthop Relat Res

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“…THA in young and active patients is a challenge [25,30]. The need for revision arthroplasty has increased owing to the higher life expectancy of these patients [12].…”

Section: Introductionmentioning

confidence: 99%

Risk Factors for Revision of Hip Arthroplasties in Patients Younger Than 30 Years

Girard

Glorion

Bonnomet

et al. 2011

Clinical Orthopaedics &Amp; Related Research

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“…Results were also excellent in selected populations with higher risk for failure: 4% loose cups at 7.4 years in rheumatoid arthritic hips [23]; 97.5% survival at 9.3 years in hip dysplasia [24]; 90% survival at 13 years in juvenile arthritis [25] and 96% at seven years in younger than 50-year-old patients [26].…”

Section: Results Of the Alloclassic-csf Cup In The Literaturementioning

confidence: 95%

Hydroxyapatite coating has no interest on grit-blasted Alloclassic-CSF titanium threaded cups

Delaunay

2007

Interact Surg

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Hydroxyapatite (HA) coating is not a sine qua non condition to achieve long-lasting acetabular cup fixation on the acetabular side of cementless primary THA, where HA acts only as an adjuvant for early osteointegration, but is not a guarantee for a long-lasting boneimplant anchorage. Of a series of 633 Alloclassic-CSF grit blasted and non-HA-coated titanium threaded cups, ten only were revised for all causes (five for infection) with no aseptic loosening. Thirteen-year survivorship with acetabular cup revision for any reason and aseptic loosening as end point was 98% (95% confidence interval, 86.9-99.7%) and 100% (90.4-100%), respectively. Failure of non-smooth cementless acetabular components might not be related to unability to achieve secure early osteointegration, but to the difficulty to maintain it with time, either due to: 1) poor liner locking mechanism; 2) conventional PE wear; or mainly 3) to acetabular bone stress shielding that could weaken the supporting bone at longer follow-up. None of these three factors can be addressed by HA coating. In fact, better strain distribution to the acetabular bone to prevent stress shielding osteopenia and the bearing materials really matter.

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Cementless Hip Arthroplasty in Juvenile Idiopathic Arthritis

Cited by 58 publications

References 19 publications

High Complication Rate in Revision Total Hip Arthroplasty in Juvenile Idiopathic Arthritis

High Complication Rate in Revision Total Hip Arthroplasty in Juvenile Idiopathic Arthritis

Risk Factors for Revision of Hip Arthroplasties in Patients Younger Than 30 Years

Hydroxyapatite coating has no interest on grit-blasted Alloclassic-CSF titanium threaded cups

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