Total Hip Arthroplasty in Young Patients

Total hip arthroplasty (THA) is the gold standard in treatment of hip arthritis yet is often avoided in young patients due to concerns of inferior survivorship. We aim to explore the role of THA in young patients and assess whether these historical concerns are valid in contemporary THA by presenting the results of: (1) a systematic review and meta-analysis of the current literature, (2) a retrospective database review, and (3) a retrospective population-based study. We found excellent long-term survivorship with modern THA in young patients, demonstrating greater than 90% revision-free survival up to 15 years. Factors that may increase risk of revision include metal-on-metal bearing surfaces, younger age, female sex, non-osteoarthritis diagnosis, early surgical complications, and low surgeon volumes. Young patients appear to benefit greatly from THA with respect to their patient-reported outcome measures. In conclusion, THA in young patients is a successful operation and should not be avoided