Total hip arthroplasty in young adults, with focus on Perthes' disease and slipped capital femoral epiphysis Follow-up of 540 subjects reported to the Norwegian Arthroplasty Register during 1987-2007
Total hip arthroplasty in young adults, with focus on Perthes' disease and slipped capital femoral epiphysis Follow-up of 540 subjects reported to the Norwegian Arthroplasty Register during 1987-2007
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DOI：
10.3109/17453674.2011.641105
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发表时间：
2012-04-01
影响因子：
3.7
通讯作者：
Engesaeter, Lars B.
中科院分区：
文献类型：
--
作者：
Lehmann, Trude G.;Engesaeter, Ingvild O.;Engesaeter, Lars B.
背景和目的 在挪威关节置换术登记册中，小儿髋关节疾病占所有初次髋关节置换术的 9%。我们希望验证登记处报告的诊断结果，并评估这些患者在髋关节置换术后的生活质量。患者和方法 540 名患者接受参加本次随访研究（634 髋）。所有患者年龄均小于 40 岁，并已向挪威关节成形术登记处报告称在 1987 年至 2007 年间接受了初次全髋关节置换术 (THA)。原始医院病历中记录了基本诊断、诊断时的年龄以及髋关节置换术前接受的治疗类型。 结果 向挪威关节成形术登记处报告的诊断在 91% 的病例 (538/592) 中被证实是正确的。对于因 Perthes 病或股骨头骨骺滑脱 (SCFE) 接受治疗的 94 个髋关节，95% 的病例 (89/94) 得到了诊断证实。炎症性髋关节疾病的相应比例为98%（137/140），而原发性骨关节炎仅为61%（19/31）。这些年轻 THA 患者的自我报告生活质量 (EQ-5D) 比来自英国和瑞典的年龄匹配队列中的患者要差，但有潜在 SCFE 的患者除外。 解释 向挪威关节置换登记处报告的 THA 根本原因诊断在 91% 的病例中是正确的。 40 岁之前接受 THA 的人的生活质量会下降，但因 SCFE 需要进行髋关节置换术的人除外。
Background and purpose 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.Patients and methods 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.Results 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.Interpretation 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.