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Cementless Ceramic-on-Ceramic Total Hip Replacement in Children and Adolescents
Background: total hip replacement (THR) is a rare surgical option in children and adolescents with disabling hip diseases. The aim of this study is to report results from a retrospective cohort of patients aged 18 years or less who underwent cementless Ceramic-on-Ceramic (CoC) THR at a single instit...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8534320/ https://www.ncbi.nlm.nih.gov/pubmed/34682123 http://dx.doi.org/10.3390/children8100858 |
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author | Trisolino, Giovanni Stallone, Stefano Castagnini, Francesco Bordini, Barbara Cosentino, Monica Lucchini, Stefano Zarantonello, Paola Ferrari, Daniele Dallari, Dante Traina, Francesco |
author_facet | Trisolino, Giovanni Stallone, Stefano Castagnini, Francesco Bordini, Barbara Cosentino, Monica Lucchini, Stefano Zarantonello, Paola Ferrari, Daniele Dallari, Dante Traina, Francesco |
author_sort | Trisolino, Giovanni |
collection | PubMed |
description | Background: total hip replacement (THR) is a rare surgical option in children and adolescents with disabling hip diseases. The aim of this study is to report results from a retrospective cohort of patients aged 18 years or less who underwent cementless Ceramic-on-Ceramic (CoC) THR at a single institution, investigating clinical and radiographic outcomes, survival rates, and reasons for revision of the implants. Materials and methods: we queried the Registry of Prosthetic Orthopedic Implants (RIPO) to identify all children and adolescents undergoing THR between 2000 and 2019 at a single Institution. Inclusion criteria were patients undergoing cementless CoC THR, aged less than 18 years at surgery, followed for at least 2 years. Sixty-eight patients (74 hips) matched all the inclusion criteria and were enrolled in the study. We assessed the clinical and radiographic outcomes, the rate of complications, the survival rate, and reasons for revision of the implants. Results: The mean follow-up was 6.6 ± 4.4 years (range 2–20). The most frequent reason for THR was post-traumatic or chemotherapy-induced avascular necrosis (38%). The overall survival rate of the cohort was 97.6% (95% CI: 84.9–99.7%) at 5 years of follow-up, 94.4% (95% CI: 79.8–98.6%) at 10 years and 15 years of follow-up. Two THR in two patients (2.7%) required revision. With the numbers available, Cox regression analysis could not detect any significant interaction between preoperative or intraoperative variables and implant survivorship (p-value 0.242 to 0.989).” The average HOOS was 85 ± 14.3 (range 30.6–100). Overall, 23 patients (48%) reported excellent HOOS scores (>90 points), 21 patients (44%) reported acceptable HOOS scores (60–90 points) while 4 patients (8%) reported poor outcomes (<60 points). Twenty-one patients (43%) were regularly involved into moderate- to high-intensity sport activities (UCLA ≥ 6). Conclusions: Cementless CoC THR is a successful procedure in children and teenagers, having demonstrated high implant survivorship and low rates of complications and failure. A meticulous preoperative planning and implant selection is mandatory, to avoid implant malposition, which is the main reason of failure and revision in these cases. Further studies are needed to assess the impact of the THR on the psychosocial wellbeing of teenagers, as well as risks and benefits and cost-effectiveness in comparison to the hip preserving surgical procedures. |
format | Online Article Text |
id | pubmed-8534320 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-85343202021-10-23 Cementless Ceramic-on-Ceramic Total Hip Replacement in Children and Adolescents Trisolino, Giovanni Stallone, Stefano Castagnini, Francesco Bordini, Barbara Cosentino, Monica Lucchini, Stefano Zarantonello, Paola Ferrari, Daniele Dallari, Dante Traina, Francesco Children (Basel) Article Background: total hip replacement (THR) is a rare surgical option in children and adolescents with disabling hip diseases. The aim of this study is to report results from a retrospective cohort of patients aged 18 years or less who underwent cementless Ceramic-on-Ceramic (CoC) THR at a single institution, investigating clinical and radiographic outcomes, survival rates, and reasons for revision of the implants. Materials and methods: we queried the Registry of Prosthetic Orthopedic Implants (RIPO) to identify all children and adolescents undergoing THR between 2000 and 2019 at a single Institution. Inclusion criteria were patients undergoing cementless CoC THR, aged less than 18 years at surgery, followed for at least 2 years. Sixty-eight patients (74 hips) matched all the inclusion criteria and were enrolled in the study. We assessed the clinical and radiographic outcomes, the rate of complications, the survival rate, and reasons for revision of the implants. Results: The mean follow-up was 6.6 ± 4.4 years (range 2–20). The most frequent reason for THR was post-traumatic or chemotherapy-induced avascular necrosis (38%). The overall survival rate of the cohort was 97.6% (95% CI: 84.9–99.7%) at 5 years of follow-up, 94.4% (95% CI: 79.8–98.6%) at 10 years and 15 years of follow-up. Two THR in two patients (2.7%) required revision. With the numbers available, Cox regression analysis could not detect any significant interaction between preoperative or intraoperative variables and implant survivorship (p-value 0.242 to 0.989).” The average HOOS was 85 ± 14.3 (range 30.6–100). Overall, 23 patients (48%) reported excellent HOOS scores (>90 points), 21 patients (44%) reported acceptable HOOS scores (60–90 points) while 4 patients (8%) reported poor outcomes (<60 points). Twenty-one patients (43%) were regularly involved into moderate- to high-intensity sport activities (UCLA ≥ 6). Conclusions: Cementless CoC THR is a successful procedure in children and teenagers, having demonstrated high implant survivorship and low rates of complications and failure. A meticulous preoperative planning and implant selection is mandatory, to avoid implant malposition, which is the main reason of failure and revision in these cases. Further studies are needed to assess the impact of the THR on the psychosocial wellbeing of teenagers, as well as risks and benefits and cost-effectiveness in comparison to the hip preserving surgical procedures. MDPI 2021-09-27 /pmc/articles/PMC8534320/ /pubmed/34682123 http://dx.doi.org/10.3390/children8100858 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Trisolino, Giovanni Stallone, Stefano Castagnini, Francesco Bordini, Barbara Cosentino, Monica Lucchini, Stefano Zarantonello, Paola Ferrari, Daniele Dallari, Dante Traina, Francesco Cementless Ceramic-on-Ceramic Total Hip Replacement in Children and Adolescents |
title | Cementless Ceramic-on-Ceramic Total Hip Replacement in Children and Adolescents |
title_full | Cementless Ceramic-on-Ceramic Total Hip Replacement in Children and Adolescents |
title_fullStr | Cementless Ceramic-on-Ceramic Total Hip Replacement in Children and Adolescents |
title_full_unstemmed | Cementless Ceramic-on-Ceramic Total Hip Replacement in Children and Adolescents |
title_short | Cementless Ceramic-on-Ceramic Total Hip Replacement in Children and Adolescents |
title_sort | cementless ceramic-on-ceramic total hip replacement in children and adolescents |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8534320/ https://www.ncbi.nlm.nih.gov/pubmed/34682123 http://dx.doi.org/10.3390/children8100858 |
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