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Hip Arthroplasty in Younger Patients (Below 30 Years): Uncemented Hip Replacement a Definite Approach

In a study, 48 total hip replacements were evaluated using an uncemented total hip prosthesis in 44 patients. Of these, 28 were females aged 30 and below. These had been diagnosed with an osteoarthritis triggered by congenital dislocations in 28 patients and the rest were diagnosed with an infection, sequelae of fracture, avascular necrosis and Calve-Legg-Perthes disease among other cases.

Experts confirmed that in all cases, uncemented straight stem fully coated with hydroxyapatite (HA) was utilized. In 36 of the cases, a hemispherical cup inserted with press fit was used, while a hemispherical screw cup was used in 7 procedures. The patients were then followed for 10 to 16 years. The finds were as follows once evaluated;

  • No stem was revised after a follow up and were all noted to have integrated properly. There were no signs of radiological loosening.

 

  • The Harris Hip score was: 88 (range: 62–100) on the average, the WOMAC score was 80 (range: 37–100), and lastly, the EuroQol score was 0.68 (range: −0.14–1)

The final findings noted;

The occurrence of mechanical failures at the acetabular side. However, there were desired results with a fully HA-coated femoral stem. There were no revisions after ten to 16 years.

Uncemented Hip Replacement Approaches in Younger Patients

Uncemented Hip Replacement Approaches in Younger Patients

The surgical approach of an uncemented hip prosthesis in all patients is believed to last longer. In case a second surgery is required, the procedure is rendered easier as opposed to the cemented hip surgery. With this, patients commonly recommend younger patients to undergo uncemented hip procedures.

This form of hip replacement surgery has proved to offer long-term clinical outcomes and the incidence of repair or re-surgery is directly reduced. When followed, patients commonly report no pain, discomfort, or stiffness from the operated hip. The radiographic outcomes indicate proper integration with no signs of radiological loosening. In addition, no stems had subsided.

 

Muscle Strength after the Surgery

Usually, the isokinetic strength measurements indicate no reduced muscle strength in the operated leg. An evaluation is generally made on both the normal and the operated leg with a main focus on the quadriceps and hamstrings.

It is therefore observed that the desired results in both the young and elderly patients aren’t altered. However, thigh pain is noted in all procedures; whether cemented or uncemented. The cause is identified as multifactorial. Cortical hypertrophy of up to 70% is reported for the case of an uncemented press fit stem.

This is believed to result from distal stress transfer to the cortical bone and an unphysiological load. The lack of radiolucent lines in the diaphysis implies a comprehensive diaphyseal bonding. In addition, new bone formation adjacent to the prosthesis is linked to a very moderate degree of bone remodelling.

Modern surgical expertise deployed during the surgery counts as a fundamental step for significant outcomes after every uncemented hip replacement surgery. An uncemented hip prosthesis is generally associated with a high level of efficacy in younger patients as clinically supported.

About The Author

Tanveer Bhutani
Eva Hospital encompasses various modern orthopedic practices pioneered by the prominent orthopedic surgeon in Ludhiana “Dr. Tanveer Singh Bhutani”.

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