Mid to long-term survivorship of hip arthroplasty in patients 40 years and younger.

IF 2.3 3区 医学 Q2 ORTHOPEDICS
Camille Vorimore, Andrew Adamczyk, Pierre Laboudie, Marc Antoine Ricard, Paul E Beaule, George Grammatopoulos
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引用次数: 0

Abstract

Background: Etiology of hip osteoarthritis (OA) and survival of hip arthroplasty in the young (below 40-years-old) remains poorly described. Furthermore, joint survivorship mid to long-term and PROMs according to the etiology are unclear. The study aims were to 1) identify the indications for arthroplasty in the below 40-years-old cohort; 2) define hip arthroplasty outcomes in the young and 3) test whether patients with sequelae of pediatrics hip disease have inferior outcome compared to other patients.

Hypothesis: Our hypothesis was that hip arthroplasty is a viable option for managing hip disease in patients under 40, with excellent survival rates and outcomes.

Material and methods: This is an IRB approved, retrospective, consecutive, multi-surgeon, cohort study from a single academic center. Indication for hip arthroplasty of 346 patients (410 hips) below 40-years-old were studied; 239 underwent THA (58%) and 171 hip resurfacing (42%). Patient, surgical and implant factors were tested for association with implant survivorship and functional outcome for hip arthroplasty performed with a follow-up of more than two years. Pediatric hip sequelae patients were compared for survival and PROMs with the rest of the cohort.

Results: The most common etiology of OA was FAI (47%), followed by pediatric hip sequelae (18%). The 10-year survivorship was 97.2% ± 1.2, mean OHS was 45.1 ± 6.3 and mean HHS was 93.4 ± 12.6. The pediatric hip sequelae subgroup demonstrated no differences in 10-year survivorship and better PROMs compared to rest (OHS: 46.6 ± 3.8; HHS: 96.0 ± 8.5).

Discussion: The most common aetiologies amongst the young with hip OA is FAI and pediatric hip sequelae. Hip arthroplasty in the young presents excellent 10-year survivorship and PROMs. Excellent survival and PROMs in the young with pediatric hip sequelae provide important information for decision-making in this challenging population.

Level of evidence: III; retrospective cohort study.

40 岁及以下患者髋关节置换术的中长期存活率。
背景:对年轻人(40 岁以下)髋关节骨性关节炎(OA)的病因和髋关节置换术后的存活率仍然知之甚少。此外,根据病因确定的关节中长期存活率和PROM也不清楚。该研究的目的是:1)确定 40 岁以下人群进行关节置换术的适应症;2)确定年轻人进行髋关节置换术的结果;3)检验小儿髋关节疾病后遗症患者的结果是否比其他患者差:我们的假设是,髋关节置换术是治疗 40 岁以下患者髋关节疾病的可行方案,具有极佳的存活率和疗效:这是一项经美国国立卫生研究院(IRB)批准的、回顾性、连续性、多外科医师、队列研究。研究对象为346名40岁以下的患者(410个髋关节),其中239人接受了THA(58%),171人接受了髋关节置换术(42%)。对随访两年以上的髋关节置换术患者、手术和植入物因素与植入物存活率和功能结果的关系进行了检测。将小儿髋关节后遗症患者的存活率和PROMs与队列中的其他患者进行了比较:结果:OA最常见的病因是FAI(47%),其次是小儿髋关节后遗症(18%)。10年存活率为97.2%±1.2,平均OHS为45.1±6.3,平均HHS为93.4±12.6。小儿髋关节后遗症亚组与其他亚组相比,10年存活率无差异,PROMs更好(OHS:46.6 ± 3.8;HHS:96.0 ± 8.5):讨论:在患有髋关节OA的年轻人中,最常见的病因是FAI和小儿髋关节后遗症。年轻人髋关节置换术的10年存活率和PROM都很高。在患有小儿髋关节后遗症的年轻人中,出色的存活率和PROMs为这一具有挑战性的人群提供了重要的决策信息:证据等级:III;回顾性队列研究。
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来源期刊
CiteScore
5.10
自引率
26.10%
发文量
329
审稿时长
12.5 weeks
期刊介绍: Orthopaedics & Traumatology: Surgery & Research (OTSR) publishes original scientific work in English related to all domains of orthopaedics. Original articles, Reviews, Technical notes and Concise follow-up of a former OTSR study are published in English in electronic form only and indexed in the main international databases.
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