Total Hip Arthroplasty in Patients Younger than 35 Is Effective Regardless of Surgical Approach

7 pages•Published: October 26, 2019

Tyler Luthringer, David Novikov, Jonathan Gabor, Hayeem Rudy, Zlatan Cizmic, Siddharth Mahure, Ran Schwarzkopf, Roy Davidovitch and Jonathan Vigdorchik

Abstract

PURPOSE: Indications for total hip arthroplasty (THA) are expanding to include increasingly younger patients, yet limited outcomes research has focused on this population. This study compares outcomes between the anterior and posterior approach, as well as between conventional and technology-assisted THA in patients under 35-years of age.

METHODS: Retrospective analysis of 139 primary THAs in 125 patients younger than 35-years old was conducted. Patients were divided into two cohorts: (1) anterior-THA and (2) posterior-THA. A posterior-THA sub-group analysis was performed to compare: (1) technology-assisted THA (tech-THA) versus (2) conventional-THA (con-THA). Demographics, perioperative data, radiographic and clinical outcomes were analyzed using Chi squared and unpaired student t-tests for categorical and continuous variables, respectively.

RESULTS: Of the 139 cases performed, 40 were anterior-THA and 99 were posterior-THA. The anterior-THA cohort had shorter mean surgical time (95.0±25.7 vs. 118.3±43.3 minutes; p<0.01), shorter hospital admissions (1.9±1.4 vs. 2.7±1.2 days; p<0.01), and lower estimated blood loss (343.4±164.1 vs. 438.0±272.8 mL; p<0.01) compared to the posterior-THA cohort. There were no significant differences in component positioning, limb length discrepancy, clinical outcomes or postoperative complications between cohorts. In the sub-group analysis, cup placement within Lewinnek’s Safe Zone was achieved in 78% of tech-THA versus 49% of con-THA (p<0.01). Need for revision THA was significantly higher among the con-THA group (9.4% vs. 0%; p<0.01).

CONCLUSION: There is no significant difference in outcomes between anterior- and posterior-THA among patients under 35-years of age, however, the anterior approach may promote earlier hospital discharge. Technological-assistance can improve component positioning and may reduce the rate of revision for posterior-THA in patients under 35-years old.

Keyphrases: hip arthroplasty, robotic surgery, young patients

In: Patrick Meere and Ferdinando Rodriguez Y Baena (editors). CAOS 2019. The 19th Annual Meeting of the International Society for Computer Assisted Orthopaedic Surgery, vol 3, pages 234-240.

Links:	https://easychair.org/publications/paper/WpSX
	https://doi.org/10.29007/fn4n

BibTeX entry

@inproceedings{CAOS2019:Total_Hip_Arthroplasty_Patients,
  author    = {Tyler Luthringer and David Novikov and Jonathan Gabor and Hayeem Rudy and Zlatan Cizmic and Siddharth Mahure and Ran Schwarzkopf and Roy Davidovitch and Jonathan Vigdorchik},
  title     = {Total Hip Arthroplasty in Patients Younger than 35 Is Effective Regardless of Surgical Approach},
  booktitle = {CAOS 2019. The 19th Annual Meeting of the International Society for Computer Assisted Orthopaedic Surgery},
  editor    = {Patrick Meere and Ferdinando Rodriguez Y Baena},
  series    = {EPiC Series in Health Sciences},
  volume    = {3},
  publisher = {EasyChair},
  bibsource = {EasyChair, https://easychair.org},
  issn      = {2398-5305},
  url       = {/publications/paper/WpSX},
  doi       = {10.29007/fn4n},
  pages     = {234-240},
  year      = {2019}}

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