Periacetabular Osteolysis is the Problem in Contemporary Total Hip Arthroplasty in Young Patients

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Abstract

We retrospectively reviewed 474 patients (492 hips) with a contemporary cemented total hip arthroplasty (THA) (mean age, 38.9 years) and 504 patients (532 hips) with a cementless THA (mean age, 39.3 years). Patients were evaluated clinically and radiographically. The mean follow-up was similar (14.5 vs 14.8 years) in both groups. The mean postoperative Harris hip scores (93.6 vs 94.7 points), the mean Western Ontario and McMaster Universities Osteoarthritis Index scores (12 vs 13 points), and the mean University of California, Los Angeles activity scores (6.9 vs 7.1 points) were similar between the 2 groups. Incidence of acetabular osteolysis (16% vs 20%) and femoral osteolysis (8% vs 9%) was similar between the 2 groups. Survivorship of cup (86% vs 82%) and stem (98% vs 98.5%) was similar between the 2 groups. Periacetabular osteolysis constitutes the major challenge in modern THAs in young patients.

Section snippets

Patients and Methods

We retrospectively reviewed the records of prospectively followed 2501 patients (2701 hips) who underwent primary THAs between January 1993 and February 2000. All operations were performed by one surgeon (YHK). Of 2501 patients, 1212 patients (1298 hips) had cemented femoral components and 1289 patients (1403 hips) had cementless femoral components. For this review, we excluded 1471 patients older than 50 years. With these exclusions, there were 1030 patients. Among the 503 patients with

Results

Harris hip score, incidence of thigh pain, WOMAC score, and UCLA activity score were improved substantially after cemented and cementless THAs. We found similar mean preoperative Harris hip score (44.5 vs 43 points, P = .69) and postoperative Harris hip scores (93.6 points vs 94.7 points, P = .78) in both groups. The prevalence of transitory pain in the thigh was 1.5% (7 of 474 patients) in the cemented group until 6 months after the operation and 11.3% (57 of 504 patients) in the cementless

Discussion

There is comparatively little information on cohorts of patients younger than 50 years with contemporary cemented and cementless THA 8, 22, although this young patient group has the largest growth projections in the future [23]. Our study documented gratifying results of femoral component with and without cement in patients younger than 50 years. Furthermore, we found no difference in the functional scores associated with the cemented and cementless implants in these young patients. We believe

Acknowledgment

The authors thank Sang-Mi Lee for her compiling medical records.

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    The Conflict of Interest statement associated with this article ca be found at doi:10.1016/j.arth.2011.03.022.

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