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Acta Orthop. 2019 Aug;90(4):331-337. doi: 10.1080/17453674.2019.1615263. Epub 2019 May 15.

Outcome of 881 total hip arthroplasties in 747 patients 21 years or younger: data from the Nordic Arthroplasty Register Association (NARA) 1995-2016.

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a Division of Orthopedic Surgery , Oslo University Hospital Ulleval , Oslo , Norway.
b Norwegian Arthroplasty Registry, Department of Orthopaedic Surgery , Haukeland University Hospital , Bergen , Norway.
c Department of Clinical Medicine , University of Bergen , Bergen , Norway.
d University of Oslo , Oslo , Norway.
e Department of Orthopaedic Surgery, Traumatology and Odense University Hospital, and Department of Clinical Research, University of Southern Denmark , Odense , Denmark.
f Danish Hip Arthroplasty Register , Denmark.
g Department of Clinical Epidemiology , Aarhus University Hospital , Aarhus , Denmark.
h The Swedish Hip Arthroplasty Register , Sweden.
i Department of Orthopaedics , Institute of Surgical Sciences, Sahlgrenska University Hospital, University of Gothenburg , Sweden.
j Coxa Hospital for Joint Replacement, and Faculty of Medicine and Life Sciences , University of Tampere , Tampere , Finland.
k The Finnish Arthroplasty Register , Finland.
l Department of Orthopaedics and Traumatology , Turku University Hospital , Turku .


Background and purpose - The literature is scarce on the outcome of the youngest patients with total hip arthroplasties (THAs). We analyzed register data, revision risk, and related factors in patients 21 years or younger with THAs in the Nordic Arthroplasty Register Association (NARA). Patients and methods - We included all THA patients 21 years or younger reported during 1995 through 2016 to the Danish, Finnish, Norwegian, and Swedish hip arthroplasty registers and merged these into the NARA dataset. Primary outcome was any implant revision. Results - We identified 881 THAs in 747 patients. Mean age at primary surgery was 18 years (9-21). The indications for THA were pediatric hip diseases (33%), systemic inflammatory disease (23%), osteoarthritis (4%), avascular necrosis (12%), hip fracture sequelae (7%), and other diagnoses (21%). Unadjusted 10-year survival for all THAs was 86%. Comparison between indications showed no differences in survival. Uncemented implants were used most frequently. Survival for uncemented and cemented implants was the same adjusted for sex, indication, head size, and time period for primary surgery. Aseptic loosening was the main cause of revision. Interpretation - Both cemented and uncemented fixations seem to be a viable option in this age group, but with a lower implant survival than in older patient groups.

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