ABSTRACT
Concerns remain about total hip arthroplasty (THA) performed in very young patients, especially those with complex medical history such as allogeneic bone marrow transplantation (ABMT). This study retrospectively reviews the perioperative courses and functional outcomes of ABMT patients <21 years old undergoing primary uncemented THA. Nine THAs were performed in five ABMT patients at an average age of 19.7 years. The interval between ABMT and THA was 73.0 months with clinical follow-up of 25.8 months. Harris Hip Scores (HHS) increased dramatically from preoperatively 44.5 (31.1-53.4) to postoperatively 85.2 (72.0-96.0) and all patients subjectively reported a good (4 hips) to excellent (5 hips) overall outcome. There was one reoperation for periprosthetic fracture fixation but there were no infections or revisions performed. Despite the history of severe hematopoietic conditions requiring ABMT, these very young patients do appear to have improved pain and function following primary THA with short-term follow-up. These results are comparable to prior studies of adult ABMT patients undergoing THA and are encouraging given the complexity of the decision to perform hip arthroplasty in the medically complicated very young patient.
Ledford CK, Vap AR, Bolognesi MP, Wellman SS. Total Hip Arthroplasty in Very Young Bone Marrow Transplant Patients. The Duke Orthop J 2014;4(1):19-23.
Multicenter randomized trial of intra venous/oral itraconazole vs. intra venous/oral fluconazole for long-term antifungal prophylaxis in allogeneic bone marrow transplant patients
