Low revision rate after total hip arthroplasty in patients with pediatric hip diseases

Abstract

Background The results of primary total hip arthroplasties (THAs) after pediatric hip diseases such as developmental dysplasia of the hip (DDH), slipped capital femoral epiphysis (SCFE), or Perthes’ disease have been reported to be inferior to the results after primary osteoarthritis of the hip (OA).Materials and methods We compared the survival of primary THAs performed during the period 1995–2009 due to previous DDH, SCFE, Perthes’ disease, or primary OA, using merged individual-based data from the Danish, Norwegian, and Swedish arthroplasty registers, called the Nordic Arthroplasty Register Association (NARA). Cox multiple regression, with adjustment for age, sex, and type of fixation of the prosthesis was used to calculate the survival of the prostheses and the relative revision risks.Results 370,630 primary THAs were reported to these national registers for 1995–2009. Of these, 14,403 THAs (3.9%) were operated due to pediatric hip diseases (3.1% for Denmark, 8.8% for Norway, and 1.9% for Sweden) and 288,435 THAs (77.8%) were operated due to OA. Unadjusted 10-year Kaplan-Meier survival of THAs after pediatric hip diseases (94.7% survival) was inferior to that after OA (96.6% survival). Consequently, an increased risk of revision for hips with a previous pediatric hip disease was seen (risk ratio (RR) 1.4, 95% CI: 1.3–1.5). However, after adjustment for differences in sex and age of the patients, and in fixation of the prostheses, no difference in survival was found (93.6% after pediatric hip diseases and 93.8% after OA) (RR 1.0, CI: 1.0–1.1). Nevertheless, during the first 6 postoperative months more revisions were reported for THAs secondary to pediatric hip diseases (RR 1.2, CI: 1.0–1.5), mainly due to there being more revisions for dislocations (RR 1.8, CI: 1.4–2.3). Comparison between the different diagnosis groups showed that the overall risk of revision after DDH was higher than after OA (RR 1.1, CI: 1.0–1.2), whereas the combined group Perthes’ disease/SCFE did not have a significantly different risk of revision to that of OA (RR 0.9, CI: 0.7–1.0), but had a lower risk than after DDH (RR 0.8, CI: 0.7–1.0).Interpretation After adjustment for differences in age, sex, and type of fixation of the prosthesis, no difference in risk of revision was found for primary THAs performed due to pediatric hip diseases and those performed due to primary OA.

Ceramic-on-ceramic THA Implants in Patients Younger Than 20 Years

“…With the numbers available, survivorship data at the most recent followup were not different between patients with osteonecrosis and patients with other diagnoses. Similar results were reported in patients who received THA after pediatric hip diseases, such as developmental dysplasia of the hip, Legg-Calvé-Perthes disease, and slipped capital femoral epiphysis [14,18]. Using merged individual-based data from the Nordic Arthroplasty Register Association, Engesaeter et al [14] compared the survival of primary THA performed in patients with developmental dysplasia, slipped capital femoral epiphysis, Perthes' disease, or primary osteoarthritis; 14,403 THAs (3.9%) were performed for sequelae of pediatric hip diseases.…”

“…Similar results were reported in patients who received THA after pediatric hip diseases, such as developmental dysplasia of the hip, Legg-Calvé-Perthes disease, and slipped capital femoral epiphysis [14,18]. Using merged individual-based data from the Nordic Arthroplasty Register Association, Engesaeter et al [14] compared the survival of primary THA performed in patients with developmental dysplasia, slipped capital femoral epiphysis, Perthes' disease, or primary osteoarthritis; 14,403 THAs (3.9%) were performed for sequelae of pediatric hip diseases. At 10 years followup, using the Kaplan-Meier method, survivorship was 93.6% for THA in pediatric hip diseases, which was not different than survivorship after THA for osteoarthritis (93.8%) after adjustment for differences in sex and age of the patients and for fixation method of the prostheses.…”

Treatment of Arthritis Associated With Legg–Calve–Perthes Disease With Modular Total Hip Arthroplasty

“…ACCEPTED MANUSCRIPT osteotomies17 . For this population, modular femoral components offer several theoretical advantages.…”

Total Hip Replacement in Patients Younger than Thirty Years 7-10 Years Follow up

“…There are few reports on the outcome of (THA) in young patients under the year of 30 with survival rates ranged from 49% to 95% [28][29][30][31]. The main reason for revision in all literature was aseptic loosening, but the majority of these studies are small number of cases and short-term follow up [32][33][34].…”