[Arthrofibrosis of the hip joint : Diagnostic and therapeutic challenge].

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Abstract

[Indexed for MEDLINE] 11. J Arthroplasty. 2025 Aug;40(8S1):S229-S235. doi: 10.1016/j.arth.2025.03.017. Epub 2025 Mar 17. Pediatric Patients Undergoing Total Hip Arthroplasty: A Single-Center Experience at Average 5.3-Year Follow-Up. Hong JX(1), Dravid A(1), Sankar WN(2), Sheth NP(3). Author information: (1)Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania. (2)Department of Orthopaedic Surgery, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania. (3)Department of Orthopaedic Surgery, Pennsylvania Hospital, Philadelphia, Pennsylvania. BACKGROUND: Total hip arthroplasty (THA) is an increasingly popular option for pediatric end-stage hip disease. However, data regarding implant longevity and functional outcomes remain limited. This case series evaluated complication and revision rates, patient-reported outcome measures (PROMs), and implant survivorship in consecutive pediatric THA patients from a single surgeon. We hypothesized that pediatric patients would have low revision rates and excellent functional outcomes at 5-year follow-up. METHODS: Following institutional review board approval, 74 patients under age 21 years who underwent 92 THAs between 2013 and 2023 were identified. Age, etiology, follow-up interval, complications, revisions, and preoperative and postoperative PROMs were recorded. The mean follow-up was 5.3 years (range, one to 11.2) and mean age at surgery was 16 years (range, 11 to 21). All patients underwent THA by the senior surgeon through a posterior (92.4%) or anterior (7.6%) approach; 90.2% received a ceramic on a highly cross-linked polyethylene bearing, with the remaining 9.8% receiving a metal femoral head. All patients received a cementless stem based on femoral morphology. No patients were lost to follow-up. RESULTS: The most common etiologies were Perthes disease and corticosteroid-induced osteonecrosis (15.2% each). A patient (1.1%) with Mucopolysaccharidosis type IV required a femoral revision for aseptic loosening; no other patients were revised. All average postoperative PROMs improved significantly (P < 0.00001): Hip Disability and Osteoarthritis Outcome Score, Joint Replacement 53.4 (interquartile range [IQR], 46.7 to 70.4) to 89.9 (IQR, 85.3 to 100), EQ-5D 0.5 (IQR, 0.2 to 0.7) to 0.8 (IQR, 0.7 to 1), and EQ visual analog scale 81 (IQR, 70 to 95) to 85 (IQR, 80 to 100). Revision-free Kaplan-Meier survivorship at 5 and 10 years was 98.9%. CONCLUSIONS: Total hip arthroplasty (THA) in patients under age 21 years yields substantial improvements in 5-year functional outcomes, regardless of etiology, with extremely low revision rates and excellent implant survivorship. Copyright © 2025 Elsevier Inc. All rights reserved. DOI: 10.1016/j.arth.2025.03.017