PMID- 30295530
OWN - NLM
STAT- MEDLINE
DCOM- 20181015
LR  - 20220129
IS  - 2049-4408 (Electronic)
IS  - 2049-4394 (Linking)
VI  - 100-B
IP  - 10
DP  - 2018 Oct
TI  - Temporal trends and survivorship of total hip arthroplasty in very young 
      patients: a study using the National Joint Registry data set.
PG  - 1320-1329
LID - 10.1302/0301-620X.100B10.BJJ-2017-1441.R2 [doi]
AB  - AIMS: The aim of this study was to describe temporal trends and survivorship of 
      total hip arthroplasty (THA) in very young patients, aged </= 20 years. PATIENTS 
      AND METHODS: A descriptive observational study was undertaken using data from the 
      National Joint Registry (NJR) for England, Wales, Northern Ireland and the Isle 
      of Man between April 2003 and March 2017. All patients aged </= 20 years at the 
      time of THA were included and the primary outcome was revision surgery. 
      Descriptive statistics were used to summarize the data and Kaplan-Meier estimates 
      calculated for the cumulative implant survival. RESULTS: A total of 769 THAs were 
      performed in 703 patients. The median follow-up was 5.1 years (interquartile 
      range (IQR) 2.6 to 7.8). Eight patients died and 35 THAs were revised. The use of 
      metal-on-metal (MoM) bearings and resurfacing procedures declined after 2008. The 
      most frequently recorded indications for revision were loosening (20%) and 
      infection (20%), although the absolute risk of these events occurring was low 
      (0.9%). Factors associated with lower implant survival were MoM and 
      metal-on-polyethylene (MoP) bearings and resurfacing arthroplasty ( vs 
      ceramic-on-polyethylene (CoP) and ceramic-on-ceramic (CoC) bearings, p = 0.002), 
      and operations performed by surgeons who undertook few THAs in this age group as 
      recorded in the NJR ( vs those with five or more recorded operations, p = 0.030). 
      Kaplan-Meier estimates showed 96% (95% confidence interval (CI) 94% to 98%) 
      survivorship of implants at five years. CONCLUSION: Within the NJR, the overall 
      survival for very young patients undergoing THA exceeded 96% during the first 
      five postoperative years. In the absence of studies that can better account for 
      differences in the characteristics of the patients, surgeons should consider the 
      association between early revision and the type of implant, the number of THAs 
      performed in these patients, and the bearing surface when performing THA in very 
      young patients. Cite this article: Bone Joint J 2018;100-B:1320-9.
FAU - Metcalfe, D
AU  - Metcalfe D
AD  - Associate Professor of Orthopaedic and Trauma Surgery Oxford Trauma, 
      NuffieldDepartment of Orthopaedics, Rheumatology and Musculoskeletal Sciences 
      (NDORMS), University of Oxford, Oxford, UK and Consultant Orthopaedic Surgeon, 
      Alder Hey Children's Hospital, Liverpool, UK.
FAU - Peterson, N
AU  - Peterson N
AD  - Specialty Registrar in Trauma & Orthopaedic Surgery, Alder Hey Children's 
      Hospital, Liverpool, UK.
FAU - Wilkinson, J M
AU  - Wilkinson JM
AD  - Department of Oncology and Metabolism, University of Sheffield, Sorby Wing, 
      Northern General Hospital, Sheffield, UK.
FAU - Perry, D C
AU  - Perry DC
AD  - Associate Professor of Orthopaedic and Trauma Surgery Oxford Trauma, 
      NuffieldDepartment of Orthopaedics, Rheumatology and Musculoskeletal Sciences 
      (NDORMS), University of Oxford, Oxford, UK and Consultant Orthopaedic Surgeon, 
      Alder Hey Children's Hospital, Liverpool, UK.
LA  - eng
GR  - CS-2014-14-012/DH_/Department of Health/United Kingdom
PT  - Journal Article
PT  - Observational Study
PL  - England
TA  - Bone Joint J
JT  - The bone & joint journal
JID - 101599229
SB  - IM
MH  - Adolescent
MH  - Age Factors
MH  - Arthroplasty, Replacement, Hip/instrumentation/*statistics & numerical data
MH  - Female
MH  - Follow-Up Studies
MH  - Hip Prosthesis
MH  - Humans
MH  - Kaplan-Meier Estimate
MH  - Male
MH  - Outcome Assessment, Health Care
MH  - Registries
MH  - Reoperation/*statistics & numerical data
MH  - Time Factors
MH  - United Kingdom
MH  - Young Adult
EDAT- 2018/10/09 06:00
MHDA- 2018/10/16 06:00
CRDT- 2018/10/09 06:00
PHST- 2018/10/09 06:00 [entrez]
PHST- 2018/10/09 06:00 [pubmed]
PHST- 2018/10/16 06:00 [medline]
AID - 10.1302/0301-620X.100B10.BJJ-2017-1441.R2 [doi]
PST - ppublish
SO  - Bone Joint J. 2018 Oct;100-B(10):1320-1329. doi: 
      10.1302/0301-620X.100B10.BJJ-2017-1441.R2.