By: 6 February 2015
Hip replacement an excellent option for young juvenile arthritis patients

A new study by Hospital for Special Surgery (HSS) researchers in New York has shown that total hip replacement is a viable option for juvenile idiopathic arthritis patients whose joints have been severely damaged by the disease.

The study, presented at the American College of Rheumatology annual meeting in November, found that hip replacement lasted at least 10 years in 85 per cent of juvenile idiopathic arthritis patients. Twenty years later, 50 per cent of the patients needed revision surgery, or a second hip replacement.

Juvenile idiopathic arthritis often persists into adulthood and frequently affects the hip joint; total hip replacement is the standard treatment to relieve pain and restore mobility when non-surgical treatments no longer help.

“The surgery in this patient population, although performed by only a small number of specialised orthopaedic surgeons nationwide, is life-changing for juvenile idiopathic arthritis patients,” said Mark Figgie, senior author of the study and chief of the Surgical Arthritis Service at HSS. “Joint replacement can free patients from a life of unrelenting pain. It can enable those in a wheelchair to walk again. Patients can go back to school or work and get their lives back.”

The study, entitled ‘Implant survival and patient-reported outcomes after total hip arthroplasty in young patients with juvenile idiopathic arthritis’ evaluated the longevity of implants in juvenile idiopathic arthritis patients aged 35 or younger who underwent hip replacement at HSS.

Patient characteristics and implant data were collected by a retrospective chart review and follow-up surveys were conducted. Kaplan-Meier survival analysis was performed to evaluate how long the implant lasted, and the hip disability and osteoarthritis outcome score (HOOS) was used to describe patient-reported outcomes.

The researchers found that hip replacement in patients who were 25 or older lasted longer compared with surgery in younger patients. There were no other significant differences in implant longevity based on gender or the use of custom versus standard implants.

Male patients reported better outcomes with respect to activities of daily living, and patients who had received custom hip implants did worse in their reporting of pain and the ability to perform daily activities.