Abstract:
Total hip arthroplasty is an effective surgical procedure in patients with end
stage hip diseases, example osteoarthritis (OA) and other degenerative hip diseases(1). In the
recent years there is an increase in indication for total hip arthroplasty among young adults(2).
The success of total hip arthroplasty with its improvement in techniques and biomaterial has
increased demand for the procedure in young adults.
The indications for primary and reoperation THA, early outcome and its associated risk factors
for total hip arthroplasty in young adults are not well known at Muhimbili orthopedic institute.
Objectives: To determine the indications, early outcome and associated risk factors for total
hip arthroplasty among young adults operated at Muhimbili orthopedic institute from 2015 to
2019.
Patients and methods:
The study design was a hospital based descriptive retrospective cross-sectional study,
involving 341 patients who underwent total hip arthroplasty at Muhimbili orthopedic institute
(MOI) between 2015 to 2019. The study was set up in accordance with the Muhimbili
University of Health and allied sciences standards using a valid structured questionnaire.
Data were retrieved from MOI total joint registry, verified from patient’s files and hospital
management information system (HMIS). Data were analyzed using statistical package for
social sciences (SPSS version 20). The approval for the study was granted by Muhimbili
University of health and allied Sciences ethical committee. Permission to conduct the study
was granted by the executive director of Muhimbili orthopedic institute.
Results
A total of 341 patients were enrolled in the study, with mean age 40± SD 12 years and male
predominance of 54.4% and female 46.6%. The leading indication for primary THA was
osteoarthritis 48.2%, followed by avascular necrosis (AVN) 27.2%, femoral neck fracture
14.4%, neglected dislocation 4.9%, acetabular fracture 3.3% and DDH 1%. In majority of
patients the implant of choice was the uncemented THA 85.6%, Hybrid THA 9.2% and the
vi
cemented THA 4.3%. Among 341 patients 36 (10.6%) showed early complications. Hip
dislocation was the leading early complication 5.3% followed by aseptic loosening 2.1%,
periprosthetic fracture 1.2%, implant mal position 1.2% and surgical site infection 0.9%. The
complications showed male predominance 52.8% and female 47.2% and increased with
advancing age, more at age group 46 to 55 years. The reoperation rate for THA within one
year was 6.2%.
Conclusion
Total hip arthroplasty is common among young adults with mean age at the fourth decade of
life. Osteoarthritis (OA) is the leading indication for primary THA followed by avascular
necrosis of femoral head, femoral neck fractures, neglected hip dislocations, acetabular
fracture, sequelae of hip infection and sequelae of childhood developmental hip dysplasia
(DDH). The predominant implant of choice was the uncemented THA. The early
complications after primary THA within one year requiring reoperations were due to hip
dislocations followed by aseptic loosening, periprosthetic fractures, implant malposition and
surgical site infection. The risk factors for reoperations within one year were associated with
advancing age of patients and male gender
