Total hip replacement in young adults with hip dysplasia: age at diagnosis, previous treatment, quality of life, and validation of diagnoses reported to the Norwegian Arthroplasty Register between 1987 and 2007

Ingvild Ø Engesæter, Trude Lehmann, Lene B Laborie, Stein Atle Lie, Karen Rosendahl, Lars B Engesæter, Ingvild Ø Engesæter, Trude Lehmann, Lene B Laborie, Stein Atle Lie, Karen Rosendahl, Lars B Engesæter

Abstract

Background and purpose: Dysplasia of the hip increases the risk of secondary degenerative change and subsequent total hip replacement. Here we report on age at diagnosis of dysplasia, previous treatment, and quality of life for patients born after 1967 and registered with a total hip replacement due to dysplasia in the Norwegian Arthroplasty Register. We also used the medical records to validate the diagnosis reported by the orthopedic surgeon to the register.

Methods: Subjects born after January 1, 1967 and registered with a primary total hip replacement in the Norwegian Arthroplasty Register during the period 1987-2007 (n = 713) were included in the study. Data on hip symptoms and quality of life (EQ-5D) were collected through questionnaires. Elaborating information was retrieved from the medical records.

Results: 540 of 713 patients (76%) (corresponding to 634 hips) returned the questionnaires and consented for additional information to be retrieved from their medical records. Hip dysplasia accounted for 163 of 634 hip replacements (26%), 134 of which were in females (82%). Median age at time of diagnosis was 7.8 (0-39) years: 4.4 years for females and 22 years for males. After reviewing accessible medical records, the diagnosis of hip dysplasia was confirmed in 132 of 150 hips (88%).

Interpretation: One quarter of hip replacements performed in patients aged 40 or younger were due to an underlying hip dysplasia, which, in most cases, was diagnosed during late childhood. The dysplasia diagnosis reported to the register was correct for 88% of the hips.

Figures

Figure 1.
Figure 1.
Flow of participants in the study.
Figure 2.
Figure 2.
A. Age at diagnosis for females (n = 95). Median age at diagnosis was 4.4 (0–38) years. B. Age at diagnosis for males (n = 9). Median age at diagnosis was 22 (9.5–39) years.
Figure 3.
Figure 3.
A. A age at THR for females (n=115). Median age of operation 14 (14–40) years. B. Age at THR for males (n=17). Median age of operation 33 (20–39) years.

References

    1. Clohisy JC, St John LC, Nunley RM, Schutz AL, Schoenecker PL. Combined periacetabular and femoral osteotomies for severe hip deformities. Clin Orthop. 2009;(467)((9)):2221–7.
    1. Dolan P. Modeling valuations for EuroQol health states. Med Care. 1997;35((11)):1095–108.
    1. Engesaeter IO, Lie SA, Lehmann TG, Furnes O, Vollset SE, Engesaeter LB. Neonatal hip instability and risk of total hip replacement in young adulthood: follow-up of 2,218,596 newborns from the Medical Birth Registry of Norway in the Norwegian Arthroplasty Register. Acta Orthop. 2008a;79((3)):321–6.
    1. Engesaeter LB, Furnes O, Havelin LI. Developmental dysplasia of the hip–good results of later total hip arthroplasty: 7135 primary total hip arthroplasties after developmental dysplasia of the hip compared with 59774 total hip arthroplasties in idiopathic coxarthrosis followed for 0 to 15 years in the Norwegian Arthroplasty Register. J Arthroplasty. 2008b;23((2)):235–40.
    1. Espehaug B, Furnes O, Havelin LI, Engesaeter LB, Vollset SE, Kindseth O. Registration completeness in the Norwegian Arthroplasty Register. Acta Orthop. 2006;77((1)):49–56.
    1. Frey L, Hauser WA. Epidemiology of neural tube defects. Epilepsia (Suppl 3) 2003;44:4–13.
    1. Furnes O, Lie SA, Espehaug B, Vollset SE, Engesaeter LB, Havelin LI. Hip disease and the prognosis of total hip replacements. A review of 53,698 primary total hip replacements reported to the Norwegian Arthroplasty Register 1987-99. J Bone Joint Surg (Br) 2001;83((4)):579–86.
    1. Garbuz DS, Awwad MA, Duncan CP. Periacetabular osteotomy and total hip arthroplasty in patients older than 40 years. J Arthroplasty. 2008;23((7)):960–3.
    1. Godward S, Dezateux C. Surgery for congenital dislocation of the hip in the UK as a measure of outcome of screening. MRC Working Party on Congenital Dislocation of the Hip. Medical Research Council. Lancet. 1998;351((9110)):1149–52.
    1. Havelin LI, Engesaeter LB, Espehaug B, Furnes O, Lie SA, Vollset SE. The Norwegian Arthroplasty Register: 11 years and 73,000 arthroplasties. Acta Orthop Scand. 2000;71((4)):337–53.
    1. Holen KJ, Tegnander A, Eik-Nes SH, Terjesen T. The use of ultrasound in determining the initiation of treatment in instability of the hip in neonates. J Bone Joint Surg (Br) 1999;81((5)):846–51.
    1. Jacobsen S, Sonne-Holm S, Soballe K, Gebuhr P, Lund B. Hip dysplasia and osteoarthrosis: a survey of 4151 subjects from the Osteoarthrosis Substudy of the Copenhagen City Heart Study. Acta Orthop. 2005;76((2)):149–58.
    1. Johnson A. Prevalence and characteristics of children with cerebral palsy in Europe. Dev Med Child Neurol. 2002;44((9)):633–40.
    1. Lehmann HP, Hinton R, Morello P, Santoli J. Developmental dysplasia of the hip practice guideline: technical report. Committee on Quality Improvement, and Subcommittee on Developmental Dysplasia of the Hip. Pediatrics. 2000;105((4)):E57.
    1. Lohmander LS, Engesaeter LB, Herberts P, Ingvarsson T, Lucht U, Puolakka TJ. Standardized incidence rates of total hip replacement for primary hip osteoarthritis in the 5 Nordic countries: similarities and differences. Acta Orthop. 2006;77((5)):733–40.
    1. Pedersen A, Johnsen S, Overgaard S, Soballe K, Sorensen HT, Lucht U. Registration in the danish hip arthroplasty registry: completeness of total hip arthroplasties and positive predictive value of registered diagnosis and postoperative complications. Acta Orthop Scand. 2004;75((4)):434–41.
    1. Reikeras O, Hinderaker T, Steen H. Reduced acetabular depth in hip instability in the newborn. Orthopedics. 1999;22((10)):943–6.
    1. Rosendahl K, Markestad T, Lie RT. Developmental dysplasia of the hip. A population-based comparison of ultrasound and clinical findings. Acta Paediatr. 1996;85((1)):64–9.
    1. Szende A, Williams A. Spring Med Publishing; 2004. Measuring Self-Reported Population Health: An International Perspective based on EQ-5D.
    1. Tellini A, Ciccone V, Blonna D, Rossi R, Marmotti A, Castoldi F. Quality of life evaluation in patients affected by osteoarthritis secondary to congenital hip dysplasia after total hip replacement. J Orthop Traumatol. 2008;9((3)):155–8.
    1. Thillemann TM, Pedersen AB, Johnsen SP, Soballe K. Implant survival after primary total hip arthroplasty due to childhood hip disorders: results from the Danish Hip Arthroplasty Registry. Acta Orthop. 2008;79((6)):769–76.
    1. Weinstein SL, Mubarak SJ, Wenger DR. Developmental hip dysplasia and dislocation: Part II. Instr Course Lect. 2004;53:531–42.

Source: PubMed

スポンサーと協力者

医学的状態

薬物療法

3
購読する