Total Hip Arthroplasty in Very Young Bone Marrow Transplant Patients

Concerns remain about total hip arthroplasty (THA) performed in very young patients, especially those with complex medical history such as allogeneic bone marrow transplantation (ABMT). This study retrospectively reviews the perioperative courses and functional outcomes of ABMT patients <21 years old undergoing primary uncemented THA. Nine THAs were performed in five ABMT patients at an average age of 19.7 years. The interval between ABMT and THA was 73.0 months with clinical follow-up of 25.8 months. Harris Hip Scores (HHS) increased dramatically from preoperatively 44.5 (range, 31.1–53.4) to postoperatively 85.2 (range, 72.0–96.0) and all patients subjectively reported a good (four hips) to excellent (five hips) overall outcome. There was one reoperation for periprosthetic fracture fixation but there were no infections or revisions performed. Despite the history of severe hematopoietic conditions requiring ABMT, these very young patients do appear to have improved pain and function following primary THA with short-term follow-up. (Journal of Surgical Orthopaedic
Advances 24(2):99–104, 2015) Key words: allogeneic bone marrow transplantation, femoral head osteonecrosis, hematopoietic stem cell transplantation, hip arthroplasty, hip dysplasia