الفهرس 
Arthroplasty Options in Dysplastic Hip in Young AdultsOnly 14 pages are availabe for public view
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Abstract
Total hip replacement is one of the most common and effective forms of surgery, resulting in generally excellent outcomes. Total hip replacement can provide pain relief and restore function in patients suffering from hip arthritis, including in those under the age of 50.
However, shortened implant longevity in this age group has been a concern because the clinical results after revision surgery are inferior to those after primary hip arthroplasty. Technical choices (approach, implants, type of fixation and bearing couple) must be made to maximise longevity based on published data and thoroughly discussed with the patient.
Additionally, we have to keep in mind that these young people will inevitably face one or more revisions in their life, due to their longer life expectancy. As a result, the implant used should have an acceptable and reliable long-term clinical outcome and it needs to be easy revisable without creating a bone stock defect.
Finally, long term results (clinical outcome and implant longevity) associated with this surgery are such that it appears unnecessary to postpone the surgery once the indication is established. Despite early concerns over prosthetic longevity in patients with higher activity levels, improvements in implant design and surgical technique have led to increased demand for THA in younger, active patients.
Earlier studies showed high revision rates following charnley low-friction arthroplasty in younger patients compared to older cohorts, with the main modes of failure being aseptic loosening and wear-induced osteolysis. Inferior implant survival in younger patients has been attributed to higher activity levels as well as a higher proportion of patients with inflammatory arthritis and congenital hip disease as their preoperative diagnosis.
Despite these challenges, recent innovations including cementless fixation and alternative bearing surfaces have shown considerable promise in addressing many previous limitations of THA in younger patients.
The study is aimed to perform an evaluation and meta-analysis of all available trials and studies demonstrating the different clinical outcomes following cemented total hip replacement in patients younger than 50 years.
This study is Published observational analytical studies (Case-control, case reference or cohort studies) on the outcomes of cemented total hip replacement in patients younger than 50 years. Trials which involve English papers from the year 2000 till 2020. Only studies on human subjects younger than 50 years were included.
The main results of the study revealed that:
6 studies were included from 2000 to 2013. There was statistically significant heterogeneity in the studies (98.21%, P <0.0001). Using the random effects model, the outcome results revealed that there was high significantly significant difference in HHS between Pre-operative and Post-operative (95% CI: -8.591 – 15.607) t=6.768, (p= <0.001*).
16 studies were included from 2000 to 2014. There was statistically significant heterogeneity in the studies (I288.47%, P <0.0001). Using the random effects model, total Event rate for revision was 17.847% (95% CI: 12.834 – 23.485).
16 studies were included from 2000 to 2014. There was statistically significant heterogeneity in the studies (I284.26%, P <0.0001). Using the random effects model, total Event rate for the acetabular components revision was 15.301% (95% CI: 11.229 – 19.875).
16 studies were included from 2000 to 2014. There was statistically significant heterogeneity in the studies (I273.55%, P <0.0001). Using the random effects model, total Event rate for the stem revision was 4.610% (95% CI: 2.838 – 6.785).
16 studies were included from 2000 to 2014. There was statistically significant heterogeneity in the studies (I284.92%, P <0.0001). Using the random effects model, total Event rate for the Aseptic loosening was 11.325% (95% CI: 8.041 – 15.089).
13 studies were included from 2002 to 2014. There was statistically significant heterogeneity in the studies (I257.75%, P 0.0048). Using the random effects model, total Event rate for the Infection2.283% (95% CI: 1.344 – 3.463).
Based on our results we recommend for further studies on larger patients and longer period of follow up to emphasize our conclusion.