Mazur Matthew, Steelman Kevin, Sayeed Zain, Chen Chaoyang, Darwiche Hussein, Little Bryan
Department of Orthopedic Surgery, Detroit Medical Center, Wayne State University, Detroit, MI, USA.
Arthroplast Today. 2023 Sep 12;23:101181. doi: 10.1016/j.artd.2023.101181. eCollection 2023 Oct.
Total hip arthroplasty (THA) procedures provide a surgical option for "ultrayoung" patients ≤30 years old with end-stage hip arthropathy. This has historically been coupled with concerns over early component failure and challenging surgical technique leading to increased risk of overall morbidity. The purpose of this study is to better elucidate the poorly defined indications and outcomes for THA in ultrayoung patients with end-stage hip disease.
A total of 40 THAs in 35 patients ≤30 years old performed at our institution from 2009 to 2016 were retrospectively followed for an average of 2 years (median 11 months, interquartile range 1-31.25). Primary outcome measure was THA revision. Patient demographics were compared against outcomes. The effects on revision rate of hip joint pathology and type of bearing surface were investigated. T-test, chi-square test, and bivariate correlation were performed to determine statistical significance ( < .05). Machine learning was used to determine the normalized important factor leading to THA revision.
Fifteen male and 25 female patients were included. Median patient age was 23 (interquartile range 19-27) years, with an average body mass index of 27.0 ± 7.9. A majority of THAs were indicated for osteonecrosis (32) and bearing surface type was predominantly metal-on-highly cross-linked polyethylene (36). The overall revision rate was 7.5%, without a correlation between revision and demographic characteristics. Revision surgery was significantly correlated with bearing surface type ( = .028). Important factors for revision were age (100%), bearing surface type (84.7%), and body mass index (52.1%).
In patients ≤30 years old, THAs performed with the use of modern implants and surgical methods show satisfactory survivorship and functional outcomes with short-term follow-up.
全髋关节置换术（THA）为30岁及以下患有终末期髋关节病的“超年轻”患者提供了一种手术选择。从历史上看，这一直伴随着对早期假体失败的担忧以及具有挑战性的手术技术，从而导致总体发病率增加的风险。本研究的目的是更好地阐明终末期髋关节疾病的超年轻患者进行THA时定义不明确的适应症和结果。
回顾性随访了2009年至2016年在我院为35例30岁及以下患者进行的40例THA，平均随访2年（中位数11个月，四分位间距1 - 31.25个月）。主要结局指标是THA翻修术。将患者人口统计学数据与结局进行比较。研究了髋关节病理和承重面类型对翻修率的影响。进行t检验、卡方检验和双变量相关性分析以确定统计学意义（P <.05）。使用机器学习来确定导致THA翻修的标准化重要因素。
纳入15例男性和25例女性患者。患者年龄中位数为23岁（四分位间距19 - 27岁），平均体重指数为27.0±7.9。大多数THA的适应症为骨坏死（32例），承重面类型主要为金属对高交联聚乙烯（36例）。总体翻修率为7.5%，翻修与人口统计学特征之间无相关性。翻修手术与承重面类型显著相关（P =.028）。翻修的重要因素为年龄（占100%）、承重面类型（占84.7%）和体重指数（占52.1%）。
在30岁及以下的患者中，采用现代植入物和手术方法进行的THA在短期随访中显示出令人满意的生存率和功能结果。
