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Original papers

Total hip arthroplasty in young adults, with focus on Perthes' disease and slipped capital femoral epiphysis

Follow-up of 540 subjects reported to the Norwegian Arthroplasty Register during 1987–2007

, , , , &
Pages 159-164 | Received 15 Apr 2011, Accepted 29 Aug 2011, Published online: 23 Nov 2011
 

Abstract

Background and purpose Pediatric hip diseases account for 9% of all primary hip arthroplasties in the Norwegian Arthroplasty Register. We wanted to validate the diagnosis as reported to the register and to assess the quality of life of these patients after hip replacement.

Patients and methods 540 patients accepted to participate in this follow-up study (634 hips). All were less than 40 years of age and had been reported to the Norwegian Arthroplasty Register as having undergone a primary total hip arthroplasty (THA) between 1987 and 2007. The underlying diagnosis, age at diagnosis, and type of treatment given prior to the hip replacement were recorded from the original hospital notes.

Results The diagnoses reported to the Norwegian Arthroplasty Register were confirmed to be correct in 91% of all cases (538/592). For the 94 hips that had been treated due to Perthes' disease or slipped capital femoral epiphysis (SCFE), the diagnosis was verified in 95% of cases (89/94). The corresponding proportion for inflammatory hip disease was 98% (137/140) and it was only 61% for primary osteoarthritis (19/31). The self reported quality of life (EQ-5D) was poorer for these young patients with THA than for persons in age-matched cohorts from Great Britain and Sweden, except for those with an underlying SCFE.

Interpretation The diagnoses reported to the Norwegian Arthroplasty Register as the underlying cause of THA were correct in 91% of cases. Individuals who undergo THA before the age of 40 have a reduced quality of life, except for those requiring a hip replacement because of SCFE.

TGL, IØE, SAL, and LBE were responsible for the study design. TGL performed the analyses and drafted the manuscript. IØE and TGL collected all the medical notes from the hospitals. All authors participated in interpretation of the results and in preparation of the manuscript.

We thank the participating hospitals for helping us find all the data, and the surgeons for reporting to the NAR. The study was supported by the Norwegian Orthopaedic Association.

No competing interests declared.