Implant survival and radiographic outcome of total hip replacement in patients less than 20 years old

Background and purpose — Total hip replacement (THR) is not recommended for children and very young teenagers because early and repetitive revisions are likely. We investigated the clini- cal and radiographic outcomes of THR performed in children and teenage patients. Patients and methods — We included 111 patients (132 hips) who underwent THR before 20 years of age. They were identifi ed in the Norwegian Arthroplasty Register, together with informa- tion on the primary diagnosis, types of implants, and any revi- sions that required implant change. Radiographs and Harris hip score (HHS) were also evaluated. Results — The mean age at primary THR was 17 (11–19) years and the mean follow-up time was 14 (3–26) years. The 10-year sur- vival rate after primary THR (with the endpoint being any revi- sion) was 70%. 39 patients had at least 1 revision and 16 patients had 2 or more revisions. In the latest radiographs, osteolysis and atrophy were observed in 19% and 27% of the acetabulae and 21% and 62% of the femurs, respectively. The mean HHS at the fi nal follow-up was 83 (15–100). Interpretation — The clinical score after THR in these young patients was acceptable, but many revisions had been performed. However, young patients with developmental dysplasia of the hip had lower implant survival. Moreover, the bone stock in these patients was poor, which could complicate future revisions.