Cementless Total Hip Arthroplasty in Young Patients under the age of 30

초록

Introduction: Total hip arthroplasty (THA) has shown exellent clinical results in coxathrosis patients, however, still controversy in young, active patients even the development of implant technology. This study was performed about clinical and radiologic outcome of the young patients who got THA under the age of 30 and the patients had been followed up more than 10 years. METHOD: This retrospective study was conducted for 45 patients (52 hips) underwent THA by a single surgeon. This study included 27 male and 18 female patients. The mean age at the index operation was 27.4 years (range 16~30) and the mean follow up period was 11.8 years (range 10~19.4 years). Most common preoperative diagnosis was avascular necrosis of femoral head (57.8%, 26cases). The used cementless acetabular components were Duraloc option cup (25 cases), Duraloc 100 series (15 cases), Duraloc 1200 series (12 cases). The used cementless femoral components were AML (46 cases), Solution (4 cases), S-ROM (2 cases). The used liner were Enduron (28 cases) and ceramic liner (24 cases). Clinical outcome was evaluated by Harrison hip evaluation score (HHS), activity level, and complications. radiolographic evaluation was assessed by the bone ingrowth, polyethylene wear and osteolysis. Results : The average HHS improved from 69.71 preoperatively to 97.12 at the last follow-up (P<0.001). Preoperatively, all patients showed a limping gait, however 6 patients still remained after surgery (P<0.001). Activity level was changed from 1.93 preoperatively to 1.30 at the last follow up (1 is heavy, 5 is sedentary). All cases showed stable bone ingrowth. 6 cases (11.5%) had osteolysis around the femoral stem and 9 cases (17.3%) had osteolysis around acetabular cup. The average wear rate of patients using polyethylene liner was 0.120 mm/year. 6 cases had undergone revision arthroplasty in follow up period. The causes of revision cases were osteolysis in 5 cases, periprosthetic fracture in 1 case. Three cas