Clinical Review
Total Hip Arthroplasty in Young Patients with Osteoarthritis
Am J Orthop. 2009 March;38(3):125-129
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Mariza Daras, MD, and William Macaulay, MD
Dr. Daras is Resident, Department of Neurology, Duke University Medical Center, Durham, North Carolina.
Dr. Macaulay is Anne Youle Stein Professor of Clinical Orthopaedic Surgery; Chief, Division of Adult Reconstruction; Director, Center for Hip and Knee Replacement, Department of Orthopaedic Surgery; and Advisory Dean, College of Physicians and Surgeons, New York–Presbyterian Hospital at Columbia University, New York, New York.
Total hip arthroplasty (THA), an effective treatment for patients with end-stage arthritic hip conditions, provides dramatic pain relief, enhances mobility, and restores function.The success of THA in older patients, in concert with improvements in techniques and biomaterials, has stimulated demand for this procedure in younger, more active patients hoping to regain full activity. Although young age remains a relative contraindication to THA, the weight of this factor has diminished. Several investigators have reported results of low-friction arthroplasty in young patients. Unfortunately, the value of these studies is limited because of heterogeneous hip pathology in the younger groups, particularly given that preoperative pathology has proved to significantly affect implant survival. In this review of the literature, we focus on THA survival in young, active patients with a preoperative diagnosis of noninflammatory osteoarthritis.