Abstract
The decision to undertake THA in a child is complex and surgery challenging. Pre-operatively patients' typically have significant pain and mobility restriction. Little is published on the functional gains after THA in this group.
The aim of this study was therefore to measure the impact THA had on the PROMS in our young patients undergoing THA, to determine QoL improvement.
This was a prospective, consecutive cohort study of patients under the age of 17 years undergoing THA by a single surgeon in a tertiary referral centre. Patient electronic notes, radiographs, and PROMS (EQ5D-Y, Oxford Hip Score (OHS) and modified Harris Hip Score (mHHS)) were reviewed.
12 children (8 females and 4 males) underwent THA before their 17th birthday, with 5 undergoing bilateral operations (17 THA total). The mean age was 14.6 years (10.75–16.9) and mean follow-up 1.5 years. Nine of the THA were undertaken for congenital syndromes, 4 for AVN, 2 for Perthe's disease and 1 for dysplasia and idiopathic chondrolysis. The mean pre-operative OHS was 15 (1–33) improving to 31 (19–39) at 6-weeks, 44 (42–46) at a year and 48 (47–48) at 3 years. mHHS improved from a pre-operative mean of 25 (0–56) to 60 (37–92) at 6-weeks, 65 (38–84) at a year and 91 (91) at 3 years. The EQ-VAS mean score pre-operatively was 35 (8–100) improving at 6-weeks to 73 (55–96), 84 (76–96) at a year and 92 (76–100) at 3 years. All patients achieved MCID or higher for OHS. 6 patients were wheelchair users preop. All patients were independent walkers at follow-up. There were no complications.
THA in children is safe and leads to a significant positive impact on QoL as measured with validated PROMS scores. Wheelchair users can reliably gain independent walking. Further follow-up is required understand the long-term outcomes.
