Total Kalça Artroplastisi Yapılan Genç Hastalarda Orta ve Uzun Dönem Sonuçların Değerlendirilmesi

Abstract

The aim of this study is to comprehensively evaluate the mid- to long-term outcomes of total hip arthroplasty in young patients in terms of clinical and radiographic findings, complication rates, and implant survival rates. The study included 134 hips of 101 patients who underwent cementless primary total hip arthroplasty in our department between 2004 and 2019, were aged 40 years or younger at the time of surgery, and had a minimum follow-up period of 5 years. The demographic characteristics of the patients, preoperative diagnoses, previous surgical histories, and details of the implants used were recorded. Clinical outcomes were assessed using the Harris Hip Score (HHS) and the Forgotten Joint Score (FJS). Radiographic evaluation was performed based on anteroposterior pelvis and lateral hip radiographs obtained preoperatively, in the early postoperative period, and during routine outpatient follow-ups. Complications, reoperations, and revision surgeries that occurred during the follow-up period were retrospectively reviewed. The mean age of the patients at the time of surgery was 29.93 years (range: 13–40), and the mean follow-up period was 10.51 years (range: 5.02–19.86). The most common indications for total hip arthroplasty were developmental dysplasia of the hip (35.1%) and avascular necrosis (22.4%). The bearing surfaces used included 56.7% ceramic-ceramic, 21.6% ceramic-polyethylene, 9% ceramic-metal, 7.5% metal-polyethylene, and 5.2% metal-metal combinations. All polyethylene liners used were highly cross-linked polyethylene. The mean preoperative Harris Hip Score was 37.84 (± 12.71), which significantly improved to 95.88 (± 6.14) at the final follow-up, with an average increase of 58.04 (± 12.47) points (p < 0.001). The median Forgotten Joint Score at the final follow-up was 81.25 (range: 20.83–100). At the end of the follow-up period, 5 hips (3.7%) underwent revision surgery. Revision-indicated complications included one aseptic loosening, three periprosthetic infections, and one recurrent dislocation. Kaplan-Meier survival analysis revealed 5-, 10-, and 15-year revision-free survival rates of 97%, 95.4%, and 95.4%, respectively. When considering revisions due to aseptic loosening alone, the revision-free survival rate was 99.3% at an average follow-up of 10.5 years. This study demonstrates that total hip arthroplasty provides excellent clinical outcomes and high survival rates in young patients.