Session Title: Orthopedics, Low Back Pain and Rehabilitation
Session Type: Abstract Submissions (ACR)
Background/Purpose : Juvenile Idiopathic Arthritis (JIA) is a common rheumatologic disease in children that often persists into adulthood. The hip joint is commonly involved, and total hip arthroplasty (THA) is the standard treatment for patients who fail non-operative management. This study evaluates implant survival in JIA patients who underwent a primary THA at our institution before the age of 35. It also describes patient-reported outcomes for JIA patients after THA.
Methods : Patient characteristics and implant data were collected by a retrospective chart review. Follow-up surveys were used to determine implant survival and patient-reported outcomes. Kaplan-Meier survival analysis was performed to evaluate implant survival, and the hip disability and osteoarthritis outcome score (HOOS) was used to describe patient-reported outcomes.
Results : Patient data was reviewed for 91 JIA patients under the age of 35 that underwent a primary THA at our institution between 1982 and 2011. Follow-up data was available for 56 patients. A preliminary analysis of 35 patients (60 primary THAs) revealed a mean time to follow-up of 12 years (Range: 2-23 years). The 10-year and 20-year implant survival was 80% (95% CI: 66%-89%) and 64% (95% CI: 46%-77%), respectively. Primary THA with standard implants had a longer survival compared to custom implants (p-value=0.02) with no other significant differences in implant survival stratified by patient age and sex, implant bearing surface, and use of cement for implant fixation. The mean HOOS scores were 89 (95% CI: 84-94) for pain, 87 (95% CI: 83-91) for symptoms, 86 (95% CI: 79-93) for ADLs, and 76 (95% CI: 69-83) for sports. Male patients reported better HOOS-Symptom scores compared to female patients (96 vs. 85, p-value=0.026), and patients with standard implants reported better HOOS-Pain (95 vs. 73, p-value <0.001) and HOOS-Symptom (91 vs. 78, p-value=0.016) scores compared to patients with custom implants.
Conclusion : THA is an excellent treatment option for JIA patients under the age of 35 with very good long-term implant survival and favorable patient-reported outcomes after surgery.
L. A. Mandl,
S. M. Goodman,
M. P. Figgie,
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/implant-survival-and-patient-reported-outcomes-after-total-hip-arthroplasty-in-young-patients-with-jia/