A poster from the University of Iowa, presented at the 25th anniversary meeting of the American Association of Hip and Knee Surgeons in Dallas, Texas November 5th through 8th, reviewed the outcome of 146 hip replacements in patients less than 55 years of age. They noted an inverse relationship between the pre-op x-ray and amount of joint space loss and improvements in function, pain and quality of life. They concluded that patients with less severe radiographic evidence of osteoarthritis had less predictable improvements in terms of function, pain relief, and activity.
They concluded that young patients who had greater than 1.5 mm of joint space remaining on plain radiographs had suboptimal outcomes from total hip replacement surgery. This reinforces one of our commonly held beliefs that the severity of arthritis preoperatively predicts the reliability of the outcome after surgery. That is the reason we try and maximize patient’s native hip using therapy, weight reduction and anti-inflammatories prior to proceeding with joint replacement surgery.