Ten Year Outcomes of Contemporary Total Hip Arthroplasty in Adolescent and Young Adult Patients are Favorable

The purpose of this study was to assess 10-year patient-reported outcome measures (PROMs), complications, polyethylene wear-rates, and implant survivorships in patients aged 30 years or younger treated with contemporary total hip arthroplasty (THA).We retrospectively assessed 121 patients (144 hips) who underwent THA at age ≤30 years (mean 23 [range, 11 to 30]) at an average follow-up duration of 10.7 years (range, 8 to 17). Highly-crosslinked polyethylene acetabular liners were used in all cases. Femoral heads were ceramic (74%) or cobalt-chrome (26%). There were 52 hips (36%) that had previous surgery and thirty-one hips (22%) were in patients who had associated major systemic co-morbidities. We analyzed the modified Harris Hip scores (mHHS), University of California Los Angeles (UCLA) Activity Scores, major complications, polyethylene wear rates, and implant survivorships.At final follow-up, the average mHHS improved from 47 (±15.1) to 81 (±19.5) with an average 34-point improvement. The UCLA scores improved from 4.0 (±2.3) to 6.0 (±2.4). The major complication rate was 5.6%. There were six hips (4.2%) that were revised. Indications for revision included instability (3, 2.1%), late infection (1, 0.7%), liner dissociation (1, 0.7%), and acetabular loosening (1, 0.7%). Mean linear (0.0438 mm/year) and volumetric (29.07 mm3/year) wear rates were low. No periprosthetic osteolysis was detected in any hip. Survivorship free from revision for any reason was 97.2, 95.8, and 95.8% at 5, 10, and 15 years, respectively. Survivorship estimates for aseptic loosening were 100, 99.3, and 99.3% at these intervals.Contemporary THA in patients ≤30 years of age is associated with marked clinical improvements at 10-year follow-up and encouraging survivorship estimates at 15 years.