Total Hip Arthroplasty in Children With Juvenile Chronic Arthritis

Abstract

From 1984 to 2002, 20 total hip arthroplasties in children with juvenile chronic arthritis were performed in the authors' department. All patients had polyarticular disease. Average age of patients was 15.8 (range 13-24) years. Early onset of the disease occurred at an average age of 7.3 (4-10) years. In six patients the physes were open at the time of surgery. All patients had complete loss of joint space and various combinations of subchondral sclerosis, flattening of the femoral head, and anterior inclination of the neck. All patients used crutches for walking and joint function was very restricted. All patients were operated on under general anesthesia. One of them was supported additionally with laryngeal mask because of cervical spine involvement. No intra- or postoperative complications occurred. Mobilization of the patients started immediately after surgery, followed by a special rehabilitation program. Follow-up examination was based on the Merle d'Aubigne et Postel scale as modified by Charnley. Patients were followed at 6 weeks and 3 months after surgery and thereafter every 6 months with clinical and radiologic examination. Average follow-up was 9.2 (2-20) years. All patients had no pain and full functional ability. Although total hip arthroplasty is technically difficult in this age, it should be performed in specialized centers because pain relief, decreased deformity, and improved quality of life can be achieved in most patients. The only disadvantage is wear of the prosthesis.

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

“…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.…”

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

“…The juvenile rheumatoid arthritis, ankylosing spondylitis, and posttraumatic osteoarthritis are the common indications for THA in the younger population in the literature [24][25][26][27].…”

Total Hip Arthroplasty in Young Adults with Stickler Connective Tissue Disorder: Review of Literature and Case

“…ere is not a great deal of information regarding the interactions between the acetabulum and femoral head during development and maturation, but it has been previously described that premature closure of the growth plate following trauma leads to subluxation of the femoral head. 40 Despite these concerns, successful surgeries on many young adults for chronic arthritis [41][42][43] or tumour resection [44][45][46][47][48] have been reported. When malignant disease is not of concern, in children and young adults it is very favorable to wait until the patient's growth plates have fused before continuing with planned hip arthroplasties.…”