Simultaneous Bilateral Total hip Arthroplasty in Patients With Juvenile Idiopathic Arthritis via Direct Anterior Approach: Long-Term Outcomes

Background: Juvenile idiopathic arthritis (JIA) often results in significant bilateral hip damage, necessitating total hip arthroplasty (THA). Simultaneous bilateral THA offers potential advantages, particularly when executed via the Direct Anterior Approach (DAA). This study aims to assess the func...

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Main Authors: Mohammadreza Razzaghof, MD, MPH, Mohammad Vahedian Ardakani, MD, Mohammad Poursalehian, MD, Seyyed Hossein Shafiei, MD, Mahlisha Kazemi, MD, Seyed Mohammad Javad Mortazavi, MD
Format: Article
Language:English
Published: Elsevier 2024-12-01
Series:Arthroplasty Today
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Online Access:http://www.sciencedirect.com/science/article/pii/S2352344124002425
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author Mohammadreza Razzaghof, MD, MPH
Mohammad Vahedian Ardakani, MD
Mohammad Poursalehian, MD
Seyyed Hossein Shafiei, MD
Mahlisha Kazemi, MD
Seyed Mohammad Javad Mortazavi, MD
author_facet Mohammadreza Razzaghof, MD, MPH
Mohammad Vahedian Ardakani, MD
Mohammad Poursalehian, MD
Seyyed Hossein Shafiei, MD
Mahlisha Kazemi, MD
Seyed Mohammad Javad Mortazavi, MD
author_sort Mohammadreza Razzaghof, MD, MPH
collection DOAJ
description Background: Juvenile idiopathic arthritis (JIA) often results in significant bilateral hip damage, necessitating total hip arthroplasty (THA). Simultaneous bilateral THA offers potential advantages, particularly when executed via the Direct Anterior Approach (DAA). This study aims to assess the functional, radiological, and patient-reported outcomes, along with the complications of bilateral uncemented THA performed via DAA in patients with JIA. Methods: A retrospective review of 39 patients with JIA who underwent bilateral THA via DAA from January 2006-January 2015 was conducted. Inclusion and exclusion criteria were defined, focusing on a minimum of 7 years of post-THA follow-up. Functional outcomes were assessed using the Harris Hip Score. Results: Data were available for 33 patients (66 hips). The mean age at surgery was 21.3 years, and the average follow-up was 11.3 years. All patients reported severe bilateral hip pain presurgery, which was alleviated post-THA. The mean preoperative Harris Hip Score improved from 49.6-79.7 postoperatively. Complications included 3 calcar cracks, 2 greater trochanter fractures, and 1 superficial wound dehiscence. No instances of dislocation, postoperative periprosthetic fracture, or any revision surgery were recorded. Conclusions: Simultaneous bilateral THA using DAA is an effective and safe surgical approach for patients with JIA with bilateral end-stage hip involvement, providing notable improvements in functional and radiological outcomes while maintaining a favorable complication profile. Level of evidence: IV.
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spelling doaj-art-96be276e5ec948649b3bc55d88ba1f7c2025-08-20T02:52:25ZengElsevierArthroplasty Today2352-34412024-12-013010155710.1016/j.artd.2024.101557Simultaneous Bilateral Total hip Arthroplasty in Patients With Juvenile Idiopathic Arthritis via Direct Anterior Approach: Long-Term OutcomesMohammadreza Razzaghof, MD, MPH0Mohammad Vahedian Ardakani, MD1Mohammad Poursalehian, MD2Seyyed Hossein Shafiei, MD3Mahlisha Kazemi, MD4Seyed Mohammad Javad Mortazavi, MD5Joint Reconstruction Research Center, Tehran University of Medical Sciences, Tehran, Iran; Department of Orthopedic Surgery, Imam Khomeini Hospital Complex, Tehran University ofMedical Sciences, Tehran, IranJoint Reconstruction Research Center, Tehran University of Medical Sciences, Tehran, Iran; Department of Orthopedic Surgery, Imam Khomeini Hospital Complex, Tehran University ofMedical Sciences, Tehran, IranJoint Reconstruction Research Center, Tehran University of Medical Sciences, Tehran, Iran; Department of Orthopedic Surgery, Imam Khomeini Hospital Complex, Tehran University ofMedical Sciences, Tehran, IranJoint Reconstruction Research Center, Tehran University of Medical Sciences, Tehran, Iran; Orthopedic Surgery Research Center, Sina University Hospital, Tehran University of MedicalSciences, Tehran, IranJoint Reconstruction Research Center, Tehran University of Medical Sciences, Tehran, Iran; Department of Orthopedics, Shariati Hospital, Tehran University of Medical Sciences, Tehran, IranJoint Reconstruction Research Center, Tehran University of Medical Sciences, Tehran, Iran; Department of Orthopedic Surgery, Imam Khomeini Hospital Complex, Tehran University ofMedical Sciences, Tehran, Iran; Corresponding author. Professor of Orthopaedic Surgery, Hip and Knee Surgeon, Joint Reconstruction Research Center, Imam Khomeini Hospital Complex, East Bagherkhan Street, North Chamran Highway, Tehran, Iran 1419733133. Tel.: +21 6658 1586.Background: Juvenile idiopathic arthritis (JIA) often results in significant bilateral hip damage, necessitating total hip arthroplasty (THA). Simultaneous bilateral THA offers potential advantages, particularly when executed via the Direct Anterior Approach (DAA). This study aims to assess the functional, radiological, and patient-reported outcomes, along with the complications of bilateral uncemented THA performed via DAA in patients with JIA. Methods: A retrospective review of 39 patients with JIA who underwent bilateral THA via DAA from January 2006-January 2015 was conducted. Inclusion and exclusion criteria were defined, focusing on a minimum of 7 years of post-THA follow-up. Functional outcomes were assessed using the Harris Hip Score. Results: Data were available for 33 patients (66 hips). The mean age at surgery was 21.3 years, and the average follow-up was 11.3 years. All patients reported severe bilateral hip pain presurgery, which was alleviated post-THA. The mean preoperative Harris Hip Score improved from 49.6-79.7 postoperatively. Complications included 3 calcar cracks, 2 greater trochanter fractures, and 1 superficial wound dehiscence. No instances of dislocation, postoperative periprosthetic fracture, or any revision surgery were recorded. Conclusions: Simultaneous bilateral THA using DAA is an effective and safe surgical approach for patients with JIA with bilateral end-stage hip involvement, providing notable improvements in functional and radiological outcomes while maintaining a favorable complication profile. Level of evidence: IV.http://www.sciencedirect.com/science/article/pii/S2352344124002425Juvenile idiopathic arthritis (JIA)Total hip arthroplasty (THA)Direct anterior approach (DAA)Bilateral hip involvementFunctional outcomes
spellingShingle Mohammadreza Razzaghof, MD, MPH
Mohammad Vahedian Ardakani, MD
Mohammad Poursalehian, MD
Seyyed Hossein Shafiei, MD
Mahlisha Kazemi, MD
Seyed Mohammad Javad Mortazavi, MD
Simultaneous Bilateral Total hip Arthroplasty in Patients With Juvenile Idiopathic Arthritis via Direct Anterior Approach: Long-Term Outcomes
Arthroplasty Today
Juvenile idiopathic arthritis (JIA)
Total hip arthroplasty (THA)
Direct anterior approach (DAA)
Bilateral hip involvement
Functional outcomes
title Simultaneous Bilateral Total hip Arthroplasty in Patients With Juvenile Idiopathic Arthritis via Direct Anterior Approach: Long-Term Outcomes
title_full Simultaneous Bilateral Total hip Arthroplasty in Patients With Juvenile Idiopathic Arthritis via Direct Anterior Approach: Long-Term Outcomes
title_fullStr Simultaneous Bilateral Total hip Arthroplasty in Patients With Juvenile Idiopathic Arthritis via Direct Anterior Approach: Long-Term Outcomes
title_full_unstemmed Simultaneous Bilateral Total hip Arthroplasty in Patients With Juvenile Idiopathic Arthritis via Direct Anterior Approach: Long-Term Outcomes
title_short Simultaneous Bilateral Total hip Arthroplasty in Patients With Juvenile Idiopathic Arthritis via Direct Anterior Approach: Long-Term Outcomes
title_sort simultaneous bilateral total hip arthroplasty in patients with juvenile idiopathic arthritis via direct anterior approach long term outcomes
topic Juvenile idiopathic arthritis (JIA)
Total hip arthroplasty (THA)
Direct anterior approach (DAA)
Bilateral hip involvement
Functional outcomes
url http://www.sciencedirect.com/science/article/pii/S2352344124002425
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