Abstract
The survivorship of contemporary total hip arthroplasty has improved substantially
as a result of the success of highly cross-linked polyethylene. Nevertheless, there
is limited information on its performance in extremely young patients. The purpose
of this study is to evaluate the (1) clinical and radiographic outcomes, (2) polyethylene
wear rates, and (3) mid-term survivorship of total hip arthroplasty in patients 21
years or younger using highly cross-linked polyethylene. After Institutional Review
Board approval, the authors identified 45 patients aged 21 years or younger (56 hips)
who underwent primary total hip arthroplasty with highly cross-linked polyethylene
at their institution by the senior author between 2000 and 2009. Patients were followed
for a minimum of 2 years, or until revision. At a mean follow-up of 57 months, modified
Harris Hip Scores, Western Ontario McMaster Universities Arthritis Index scores, Short
Form-12 physical function scores, and University of California, Los Angeles activity
scores improved significantly in all patients. There was no radiographic evidence
of osteolysis in any patient. The mean linear polyethylene wear rate was 0.02 mm per
year. Survivorship was 98% with one revision for acetabular loosening at 71 months.
Total hip arthroplasty in patients 21 years or younger with highly cross-linked polyethylene
had excellent clinical and radiographic outcomes at mid-term follow-up. Longer-term
data are needed in this patient population to confirm continued survivorship in the
extremely young. The level of evidence used for this study was level III.
Keywords
total hip arthroplasty - young patients - highly cross-linked polyethylene - wear
analysis
