Research Article: Total hip arthroplasty in young adults, with focus on Perthes’ disease and slipped capital femoral epiphysis

Date Published: April 24, 2012

Publisher: Informa Healthcare

Author(s): Trude G Lehmann, Ingvild Ø Engesæter, Lene B Laborie, Stein Atle Lie, Karen Rosendahl, Lars B Engesæter.


Pediatric hip diseases account for 9% of all primary hip arthroplasties in the Norwegian Arthroplasty Register. We wanted to validate the diagnosis as reported to the register and to assess the quality of life of these patients after hip replacement.

540 patients accepted to participate in this follow-up study (634 hips). All were less than 40 years of age and had been reported to the Norwegian Arthroplasty Register as having undergone a primary total hip arthroplasty (THA) between 1987 and 2007. The underlying diagnosis, age at diagnosis, and type of treatment given prior to the hip replacement were recorded from the original hospital notes.

The diagnoses reported to the Norwegian Arthroplasty Register were confirmed to be correct in 91% of all cases (538/592). For the 94 hips that had been treated due to Perthes’ disease or slipped capital femoral epiphysis (SCFE), the diagnosis was verified in 95% of cases (89/94). The corresponding proportion for inflammatory hip disease was 98% (137/140) and it was only 61% for primary osteoarthritis (19/31). The self reported quality of life (EQ-5D) was poorer for these young patients with THA than for persons in age-matched cohorts from Great Britain and Sweden, except for those with an underlying SCFE.

The diagnoses reported to the Norwegian Arthroplasty Register as the underlying cause of THA were correct in 91% of cases. Individuals who undergo THA before the age of 40 have a reduced quality of life, except for those requiring a hip replacement because of SCFE.

Partial Text

500 patients (344 females, 592 THAs) were included. Except for more females attending (p = 0.008), there were no statistically significant differences in baseline characteristics between the 500 attendees and the 213 non-attendees (Table 1). Mean age at the time of hip replacement was 29 (12–41) years, with no significant differences between the sexes. Mean age at follow-up was 35 (17–41) years.

We found that the underlying cause of total hip replacement was correctly reported to the NAR in 91% of all subjects less than 40 years of age and in 95% of patients operated due to Perthes’ disease or SCFE. Except for those operated due to an underlying SCFE, quality of life as assessed by the EQ-5D index was poorer than in age-matched cohorts.