Osteonecrosis of the hip is a clinical, radiographic, and pathologic entity that commonly affects young patients. This study evaluates long-term implant survival and patient-reported outcomes after primary total hip arthroplasty (THA) in patients with osteonecrosis aged 35 or younger.
A retrospective study with prospective follow-up was conducted at a major academic medical center. Chart review was performed to identify young THA patients with osteonecrosis, and follow-up surveys were conducted to determine implant survival and patient-reported outcomes. Kaplan-Meier survival analysis was performed to evaluate implant survival, and the hip disability and osteoarthritis outcome score (HOOS) was used to describe patient-reported outcomes.
The study included 135 patients (204 THAs) with a mean time to follow-up of 14 years. In this group, 10-year implant survival was 86% and 20-year implant survival was 66%. Implant survival was longer in male patients (p = 0.02) and patients that were over the age of 25 at the time of surgery (p = 0.03). The mean HOOS scores at follow-up were 87 for pain, symptoms, and ADLs, and 77 for sports. All HOOS measures were lower in patients that underwent a revision THA, and HOOS-Pain and HOOS-Sport scores were lower in patients that were over the age of 25 at the time of surgery (p<0.05).
Young patients with osteonecrosis have good implant survival and long-term outcomes after THA. Patient factors and implant characteristics should be considered when predicting implant survival and outcomes after THA in young patients with osteonecrosis.
Hip Int 2017; 27(3): 286 - 292
Article Type: ORIGINAL RESEARCH ARTICLE
AuthorsIshaan Swarup, Marisa Shields, Erik N. Mayer, Chelsea J. Hendow, Jayme C. Burket, Mark P. Figgie
- • Accepted on 14/08/2016
- • Available online on 31/01/2017
- • Published in print on 12/05/2017
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- Swarup, Ishaan [PubMed] [Google Scholar] 1, * Corresponding Author (email@example.com)
- Shields, Marisa [PubMed] [Google Scholar] 1
- Mayer, Erik N. [PubMed] [Google Scholar] 2
- Hendow, Chelsea J. [PubMed] [Google Scholar] 3
- Burket, Jayme C. [PubMed] [Google Scholar] 4
- Figgie, Mark P. [PubMed] [Google Scholar] 1
Department of Orthopaedic Surgery, Hospital for Special Surgery, New York - USA
David Geffen School of Medicine at UCLA, Los Angeles - USA
New York Medical College, Valhalla - USA
Healthcare Research Institute, Hospital for Special Surgery, New York - USA