Total Hip Arthroplasty in Young Patients in The Netherlands: Trend Analysis of >19,000 Primary Hip Replacements in the Dutch Arthroplasty Register

Introduction In the United Kingdom, over 83,000 primary total hip arthroplasties (THAs) were performed last year, of which 20% are in patients under the age of 60 years. These patients generally have a longer life expectancy and a higher activity level than an older cohort, which may potentially translate to higher revision rates. Methods We reviewed our Trent regional arthroplasty register to assess current surgical practice in younger patients undergoing total hip arthroplasty. The results were compared to a previous study published in 2005. Results Between 2010 and 2012, 1,097 primary THAs were performed on patients aged 54 or less. There was an equal cohort of males to females with a mean age of 46 years of patients undergoing THA. Osteoarthritis was the commonest aetiology for patients having surgery. Reviewing the components used there were 32 different femoral and 30 different acetabular types along with 70 different combinations of components. There were 608 uncemented THAs, 313 hybrid THRs, 98 cemented THAs, 67 resurfacing arthroplasties and 11 reverse hybrid THAs. Discussion The majority of implants were uncemented in both femur and acetabulum with consultants performing most of the procedures. There is a clear preference for uncemented femoral and acetabular fixation in the younger patient, and the trend towards uncemented components has increased over the last 10 years amongst the same surgeons. There continues to be a wide variety of cup and stem usage along with many different combinations of components, with no consensus on the ideal combination.

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Uncemented total hip arthroplasty for primary osteoarthritis in young patients: A mid- to long-term follow-up study from the Finnish Arthroplasty Register

Yearbook of Orthopedics ◽

10.1016/s0276-1092(08)79174-0 ◽

2008 ◽

Vol 2008 ◽

pp. 244-247

Author(s):

C.P. Beauchamp

Keyword(s):

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Young Patients ◽

Arthroplasty Register ◽

Total Hip ◽

Follow Up Study ◽

Uncemented Total Hip Arthroplasty ◽

Long Term Follow Up

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A significant change towards cemented fixation in revision total hip arthroplasty in patients younger than 55 years in the Netherlands: results of an observational cohort study in the Dutch Arthroplasty Register in 28,516 primary hip replacements and 1285 revision procedures

Hip International ◽

10.1177/11207000211020002 ◽

2021 ◽

pp. 112070002110200

Author(s):

Martijn FL Kuijpers ◽

Gerjon Hannink ◽

Liza N van Steenbergen ◽

B Wim Schreurs

Keyword(s):

The Netherlands ◽

Hip Arthroplasty ◽

Young Patients ◽

Fixation Method ◽

Term Survival ◽

Arthroplasty Register ◽

Total Hip ◽

Significant Difference ◽

Revision Tha ◽

Significant Change

Background: Worldwide, the majority of total hip arthroplasties (THAs) placed in patients <55 years are uncemented. However, little is known about the preferred method of fixation in revision hip arthroplasty in young patients. The aim of this study was to assess potential differences in the method of fixation used between primary and revision THA in young patients using data from the Dutch Arthroplasty Register. Methods: All primary THA placed in patients younger than 55 years, registered in the LROI between 2007 and 2019 were included n = 28,516). Kaplan-Meier survival analyses were used to estimate the survival of primary THA by method of fixation. Additionally, survival of revision procedures that changed or did not change in method of fixation were estimated. McNemar’s test was used to assess differences in the proportion of cemented and uncemented fixation between primary and revision THA. Results: In all acetabular revisions, the use of cemented fixation increased statistically significant with 39% (95% CI, 34–45, p < 0.001) from 23% in primary THA to 62% in revision procedures. In all femoral revisions, the increase of cemented fixation was also statistically significant with 25% (95% CI, 19–31, p < 0.001), from 11% in primary THA to 36% in revision surgery. For both revised acetabular and femoral components, we found no statistically significant difference in the 5-year survival between revision procedures that changed or did not change in method of fixation. Conclusions: There was a significant change towards cemented fixation between primary and revision THA in young patients in the Netherlands, which was especially pronounced in acetabular revisions. No significant difference in short-term survival was found between revision procedures that changed or did not change in method of fixation. Long-term follow-up data are needed to evaluate the effect of this change in fixation method on the outcome of revision procedures in young patients.

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Epidemiological Study of Femoral Head Osteonecrosis

Revista de Chimie ◽

10.37358/rc.17.5.5593 ◽

2017 ◽

Vol 68 (5) ◽

pp. 974-976

Author(s):

Alexandru Patrascu ◽

Liliana Savin ◽

Dan Mihailescu ◽

Victor Grigorescu ◽

carmen Grierosu ◽

...

Keyword(s):

Risk Factors ◽

Femoral Head ◽

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Young Patients ◽

Head Group ◽

Bipolar Hemiarthroplasty ◽

Aseptic Necrosis ◽

Total Hip ◽

Femoral Head Osteonecrosis

In recent years, there has been an increase in the number of studies on the etiology of femoral head necrosis. We retrospectively reviewed all patients diagnosed with aseptic necrosis of the femoral in the period of 2010-2015. We recorded a total of 230 cases diagnosed with aseptic necrosis of the femoral head, group was composed of 65.7% men and 34.3% women, risk factors identified was 19.13% (post-traumatic), 13.91% (glucocorticoids), 26.52% (alcohol), 3.47% (another cause) and in 36 95% of the cases no risk factors were found. The results of the study based on the type of surgery performed on the basis of stages of disease progression, 8 patients (3.48%) benefited from osteotomy, 28 patients (12.17%) benefited of bipolar hemiarthroplasty prosthesis and 188 patients (81.74%) benefited of total hip arthroplasty. Osteonecrosis of the femoral head is characteristic to young patients between the age of 30-50 years old. Predisposing factors, alcohol and corticosteroid therapy remains an important cause of the disease. Total hip arthroplasty remains the best option for the patients with osteonecrosis of the femoral head.

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