Medium-term outcomes of total hip arthroplasty in juvenile patients
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(2020) 15:476
RESEARCH ARTICLE
Open Access
Medium-term outcomes of total hip arthroplasty in juvenile patients Francesco Luceri1†, Ilaria Morelli2†, Carlo Maria Sinicato3, Alberto Della Grazia4, Fabio Verdoni1, Nicola Maffulli5,6,7* , Giuseppe M. Peretti1,8† and Domenico Curci1†
Abstract Background: Juvenile hip osteoarthritis is often the end result of congenital conditions or acquired hip ailments occurred during the paediatric age. This study evaluated the middle term results of total hip arthroplasty for endstage juvenile hip osteoarthritis. Materials and methods: This is a retrospective analysis of prospectively collected data on a cohort of 10 consecutive patients (12 hips), aged between 14 and 20 at operation, who underwent cementless total hip arthroplasty for end-stage juvenile secondary hip osteoarthritis in two orthopaedic tertiary referral centres between 2009 and 2018. Results: Juvenile hip osteoarthritis occurred as a consequence of developmental dysplasia of the hip, Legg-CalvéPerthes disease, femoral head necrosis or slipped capital femoral epiphysis. All patients showed a significant improvement in Harris Hip Score (p < 0.01) at 3.3 years average follow-up (range 0.7–10.1 years). Conclusion: The management of juvenile hip osteoarthritis following developmental dysplasia of the hip, LeggCalvé-Perthes disease, femoral head necrosis or slipped capital femoral epiphysis is still challenging. Careful preoperative planning is essential to achieve good outcomes and improve the Harris Hip Score in these young patients. Total hip arthroplasty is a suitable option for end-stage secondary juvenile hip osteoarthritis, when proximal femoral osteotomies and conservative treatments fail to improve patients’ symptoms and quality of life. Level of evidence: IV Keywords: Total hip arthroplasty, Paediatric, Juvenile hip osteoarthritis, Total hip replacement, Case series
Introduction Osteoarthritis of the hip may be the end result of congenital or acquired hip conditions occurred during the juvenile age [1]. Developmental dysplasia of the hip (DDH), Legg-Calvé-Perthes disease (LCPD), slipped * Correspondence: [email protected] † Francesco Luceri and Ilaria Morelli have contributed equally to this work and share the first name position in the author list. † Domenico Curci and Giuseppe M. Peretti have contributed equally as senior authors to this work and share the last position in the author list. 5 San Giovanni di Dio e Ruggi D’Aragona Hospital “Clinica Ortopedica” Department, University of Salerno, Salerno, Italy 6 School of Pharmacy and Bioengineering, Keele University School of Medicine, Thornburrow Drive, Stoke on Trent, England Full list of author information is available at the end of the article
capital femoral epiphysis (SCFE) and hip joint infections are the most common cause of juvenile hip osteoarthritis (JHOA) [2]. The complex management and the catastrophic consequences of these conditions justify the active research interest in this field [3–6]. DDH ranges from mild dysplasia of the acetabulum
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