Outcome measures and survivorship following total hip arthroplasty in adolescent population,International Orthopaedics

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Outcome measures and survivorship following total hip arthroplasty in adolescent population
International Orthopaedics ( IF 2.0 ) Pub Date : 2022-08-09 , DOI: 10.1007/s00264-022-05536-5
Ricardo Fernandez-Fernandez ₁ , Luis Moraleda-Novo ₁ , Joaquin Nuñez De Armas ₁ , Ana Cruz-Pardos ₁

Affiliation

Background

The most frequent indication for total hip arthroplasty (THA) in adolescent patients has been juvenile idiopathic arthritis (JIA). However, in recent years, other causes have become more prevalent.

Questions/Purposes: (1) What is the survivorship following THA across the diagnostic spectrum in adolescent population? (2) How are quality of life results affected by systemic medical conditions?

Methods

We retrospectively reviewed all consecutive THA in patients under 21 years of age, performed at our Institution between 1993 and 2018. There were 34 prostheses implanted in 26 patients with a mean age of 18.4 years (range 11 to 21). The most frequent diagnosis was JIA (14 hips), followed by avascular necrosis (10 hips). Patient reported outcomes were assessed using Harris and Oxford Hip Scores (HHS and OHS), Visual Analogue Scale (VAS) and EuroQol-5D. Survivorship for revision and aseptic loosening was determined with Kaplan Meier analysis.

Results

At final follow-up, the overall survival rate was of 89.3% at 12-year follow-up. Three acetabular components underwent revision surgery for aseptic loosening. Clinical HHS significantly improved from 37.5 to 90.6 points (p < 0.001). Mean OHH was 37.4 points, with a final VAS of 1.64 points. Mean 5Q-5D was 0.704 with an interquartile range of 0.4 to 1.0. JIA patients displayed worse pre-operative HHS scores, and at final follow-up had worse HHS, OHS, VAS and EQ-5D scores compared to the rest of the patients. Complications included three intra-operative femoral fractures, one sciatic nerve palsy and one adductor contracture.

Conclusion

THA in adolescent patients provides improved functional outcomes with acceptable revision rates at mid-term follow-up.

中文翻译：

青少年人群全髋关节置换术后的结果测量和生存率

背景

青少年患者进行全髋关节置换术 (THA) 最常见的适应症是幼年特发性关节炎 (JIA)。然而，近年来，其他原因变得更加普遍。

问题/目的：(1) 在青少年人群的整个诊断范围内，THA 后的存活率是多少？(2) 全身医疗条件如何影响生活质量结果？

方法

我们回顾性地回顾了 1993 年至 2018 年间在我们机构对 21 岁以下患者进行的所有连续 THA。26 名平均年龄为 18.4 岁（范围为 11 至 21 岁）的患者植入了 34 个假体。最常见的诊断是 JIA（14 髋），其次是缺血性坏死（10 髋）。使用 Harris 和 Oxford 髋关节评分（HHS 和 OHS）、视觉模拟量表 (VAS) 和 EuroQol-5D 评估患者报告的结果。使用 Kaplan Meier 分析确定翻修和无菌松动的存活率。

结果

在最后一次随访时，12 年随访的总生存率为 89.3%。三个髋臼假体因无菌性松动而接受了翻修手术。临床 HHS 从 37.5 分显着提高到 90.6 分 ( p < 0.001)。平均 OHH 为 37.4 分，最终 VAS 为 1.64 分。平均 5Q-5D 为 0.704，四分位数范围为 0.4 至 1.0。与其他患者相比，JIA 患者术前 HHS 评分更差，最终随访时 HHS、OHS、VAS 和 EQ-5D 评分更差。并发症包括 3 例术中股骨骨折、1 例坐骨神经麻痹和 1 例内收肌挛缩。