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THA with alternate bearings produced good results in adolescent patients
Kamath AF. J Arthroplasty. 2011. doi:10.1016/j.arth.2011.04.042.
Modern alternate-bearing total hip arthroplasty yielded favorable intermediate clinical and radiographic results in patients younger than 21 years, according to researchers.
“Total hip arthroplasty (THA) is not commonly performed in adolescents,” Atul F. Kamath, MD, University of Pennsylvania, Philadelphia, and colleagues wrote. “However, it may be the only option for pain control and continued mobility for advanced disease.”
The researchers described their experience with modern alternative-bearing THA in 18 patients (21 THAs) who were younger than 21 years. They recorded preoperative and postoperative Harris hip scores, and they reviewed radiographs. Average follow-up was 49 months. Mean patient age was 18 years.
The patients had these underlying etiologies: chemotherapy-induced necrosis (33%), steroid-induced osteonecrosis (29%), sickle cell disease (24%) and chronic dislocation (14%). The bearings used were ceramic/ceramic (67%), metal/highly crosslinked polyethylene (29%) and metal resurfacing (5%).
The results showed that Harris hip scores improved from 43.6 to 83.6. At final follow-up, there were no cases of radiographic loosening, and surgeons revised one case for a cracked ceramic liner.