Cementless Ceramic-on-Ceramic Total Hip Replacement in Children and Adolescents
<i>Background</i>: 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...
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-09-01
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| Series: | Children |
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| Online Access: | https://www.mdpi.com/2227-9067/8/10/858 |
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| author | Giovanni Trisolino Stefano Stallone Francesco Castagnini Barbara Bordini Monica Cosentino Stefano Lucchini Paola Zarantonello Daniele Ferrari Dante Dallari Francesco Traina |
| author_facet | Giovanni Trisolino Stefano Stallone Francesco Castagnini Barbara Bordini Monica Cosentino Stefano Lucchini Paola Zarantonello Daniele Ferrari Dante Dallari Francesco Traina |
| author_sort | Giovanni Trisolino |
| collection | DOAJ |
| description | <i>Background</i>: 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. <i>Materials and methods</i>: 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. <i>Results</i>: 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 (<i>p</i>-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). <i>Conclusions</i>: 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. |
| first_indexed | 2024-03-10T06:38:16Z |
| format | Article |
| id | doaj.art-21fd604875b54161b9f81b25ff62abdb |
| institution | Directory Open Access Journal |
| issn | 2227-9067 |
| language | English |
| last_indexed | 2024-03-10T06:38:16Z |
| publishDate | 2021-09-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Children |
| spelling | doaj.art-21fd604875b54161b9f81b25ff62abdb2023-11-22T17:50:13ZengMDPI AGChildren2227-90672021-09-0181085810.3390/children8100858Cementless Ceramic-on-Ceramic Total Hip Replacement in Children and AdolescentsGiovanni Trisolino0Stefano Stallone1Francesco Castagnini2Barbara Bordini3Monica Cosentino4Stefano Lucchini5Paola Zarantonello6Daniele Ferrari7Dante Dallari8Francesco Traina9Pediatric Orthopedics and Traumatology, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, ItalyPediatric Orthopedics and Traumatology, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, ItalyOrthopaedic-Traumatology and Prosthetic Surgery and Revisions of Hip and Knee, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, ItalyMedical Technology Laboratory, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, ItalyMedical Technology Laboratory, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, ItalyOrthopaedic-Traumatology and Prosthetic Surgery and Revisions of Hip and Knee, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, ItalyPediatric Orthopedics and Traumatology, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, ItalyPediatric Orthopedics and Traumatology, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, ItalyConservative Orthopedic Surgery and Innovative Techniques, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, ItalyOrthopaedic-Traumatology and Prosthetic Surgery and Revisions of Hip and Knee, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy<i>Background</i>: 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. <i>Materials and methods</i>: 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. <i>Results</i>: 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 (<i>p</i>-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). <i>Conclusions</i>: 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.https://www.mdpi.com/2227-9067/8/10/858arthroplastyreplacementhipchildadolescentceramics |
| spellingShingle | Giovanni Trisolino Stefano Stallone Francesco Castagnini Barbara Bordini Monica Cosentino Stefano Lucchini Paola Zarantonello Daniele Ferrari Dante Dallari Francesco Traina Cementless Ceramic-on-Ceramic Total Hip Replacement in Children and Adolescents Children arthroplasty replacement hip child adolescent ceramics |
| 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 | arthroplasty replacement hip child adolescent ceramics |
| url | https://www.mdpi.com/2227-9067/8/10/858 |
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