Indications and early outcome of total hip arthroplasty in young adults at Muhimbili Orthopaedic Institute, Tanzania

Abstract

Background: Total hip arthroplasty is an effective surgical procedure in patients with advanced hip pathologies. The newer techniques,  implants and improved functional outcomes have increased demand for the procedure in young adults. The indications for primary and  revision total hip arthroplasty, early outcome and its associated risk factors in young adults are not well known at Muhimbili Orthopaedic institute.

Objectives: To determine the indications, early outcome and associated risk factors for total hip arthroplasty among young adults  operated at Muhimbili Orthopaedic Institute.

Methods: A descriptive retrospective cross-sectional study, involving 341 patients who  underwent total hip arthroplasty. Data was retrieved from total joint registry, verified from patient’s files and hospital management  information system and analyzed using Statistical Package for Social Sciences version 20.

Results: A total of 341 patients were enrolled in  the study, with a mean age of 40 ± 12 years with a slight male predominance of 54.4%. The leading indication for primary total hip  arthroplasty was osteoarthritis (48.2%). Other indications included avascular necrosis (27.2%), femoral neck fracture (14.4%), neglected  dislocation (4.9%), acetabular fracture (3.3%) and developmental dysplasia of the hip (1%). In majority (85.6%) of patients the implant of  choice was uncemented, whilst the hybrid was used in 9.2% and cemented implants in 4.3% of the patients. Thirty six patients (10.6%) had  early complications including hip dislocation (5.3%), aseptic loosening (2.1%), peri-prosthetic fracture (1.2%), implant malposition  (1.2%) and surgical site infection (0.9%). The reoperation rate within one year was 6.2%.

Conclusion: Total hip arthroplasty is becoming  increasingly common among young adults. Osteoarthritis is the leading indication for primary total hip replacement. Early complications  within one year included hip dislocation, aseptic loosening, periprosthetic fracture, implant malposition and surgical site infection. The  risk factors for reoperations within one year were associated with advanced age and male gender.