BOSTON—A new study finds that total hip replacement (THR) is an excellent option for patients under age 35, when traditional treatments fail to provide relief. The study, presented at the 2014 American College of Rheumatology Annual Meeting, found that hip replacement lasted at least 10 years in 85% of juvenile idiopathic arthritis (JIA) patients. Twenty years later, 50% of the patients needed a revision surgery.
“Joint replacement can free patients from a life of unrelenting pain. It can enable those in a wheel chair to walk again. Patients can go back to school or work and get their lives back,” said Mark P. Figgie, MD, senior author of the study and Chief of the Surgical Arthritis Service at the Hospital for Special Surgery in New York.
Mark P. Figgie, MD
This study evaluated the longevity of implants in juvenile idiopathic arthritis patients ages 35 or younger who underwent hip replacement at Hospital for Special Surgery. “This study followed one of the largest cohorts of patients with JIA to see how they fared 10 years after total hip replacement,” said coinvestigator Ishaan Swarup, MD, an orthopedic resident at the Hospital for Special Surgery. “It is also one of the few studies to look at patient-reported measures, such as pain and the ability to perform activities of daily living.”
Data were collected retrospectively for 56 patients. Forty-one patients had undergone bilateral hip replacement, while 15 individuals had only one side replaced, for a total of 97 hip replacement surgeries. The mean time for follow-up was 12 years. The 10-year and 20-year implant survival was 85% and 50%, respectively.
The researchers found that hip replacement in patients who were 25 or older lasted longer compared to total hip replacement in younger patients. There were no other significant differences in implant longevity based on gender or the use of custom versus standard implants.
Overall, male patients reported better outcomes with respect to activities of daily living. Patients who had received custom hip implants did worse in their reporting of pain and the ability to perform daily activities.
“We were not surprised that the patients who received custom implants had lower scores, since the very fact that they needed a custom implant meant they had more severe joint deformities and more severe disease,” stated Dr. Figgie.