Single-stage bilateral total hip arthroplasty in patients less than 35 years Forty arthroplasties with 5-17 years follow-up

Published online: Apr 27 2009

Jean-Pierre Simon, Evelyne Robbens, Michael Maes, Johan Bellemans

From the University Hospital Pellenberg, Leuven, Belgium


Between 1991 and 2003, the senior author performed 42 bilateral total hip arthroplasties as a single-stage procedure in 21 patients less than 35 years old. One patient was lost to follow-up, leaving 40 total hip arthroplasties in 11 male and 9 female patients for review, with a mean follow-up of 9.7 years (5-17 years). The mean age at the index operation was 25.2 years (range 17 to 34 years). The underlying hip disease was inflammatory arthritis in 13 patients and avascular necrosis in 7 patients. The femoral implants were cemented polished, tapered stems in all patients. Cementless porous-coated acetabular components were used in 34 hips, cemented metal backed cups in 4 hips and all polyethylene cemented cups in 2 hips. Clinical evaluation with the Charnley modification of the Merle-d'Aubigné Postel score showed significant improvement after surgery. In a questionnaire concerning their daily activities, professional occupation, social life and sexual activity all but one patient rated the result of their bilateral THA as good or excellent and stated they would have repeated the intervention if necessary. All patients were able to walk without any walking aid within 3 months after surgery. There were no differences in the outcome between the two groups of patients. Three metal backed cemented cups in 2 patients failed and had to be revised at 11, 13 and 16 years after the primary operation. Radio graphic analysis of the surviving cups showed radiolucencies in one metal backed cemented and one uncemented socket. Femoral lucencies appeared in two hips, and calcar resorption in three femurs. With a mean follow-up of 9.7 years the survival of the cemented polished femoral components is 100%. One patient had grade 2 heterotopic ossifications in both hips. There was one superficial wound infection. No other complications occurred. Bilateral single-stage conventional total hip arthroplasty provided favorable medium term results in patients less than 35 years-old without any major or minor complications.