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Anthony Young

Publications and source records attributed to Anthony Young.

3 recordsLinked to original sources

Second-generation porous-coated cementless total hip arthroplasties have high survival.

We retrospectively reviewed 157 consecutive total hip arthroplasties performed with Prodigy stems and Duraloc cups to see whether design modifications made to these components would improve their clinical performance as compared with first-generation porous-coated components. At an average of 6.7 years postoperatively, 145 hips were available for followup. The data suggested encouraging clinical and radiographic performances for these second-generation components. With only two hips (1.4%) in this population being revised, survivorship analysis was 99% 5 years postoperatively. Bone ingrowth was evident in 99% of the stems, and all cups were stable at last followup. Large osteolytic lesions were observed in three acetabula and seven femurs with all femoral lesions being confined to the proximal Gruen Zones 1 or 7. Polyethylene wear averaged 0.10 +/- 0.14 mm/year. Ninety-eight percent of patients reported satisfaction with the procedure, and 7% reported activity-limiting pain. Early followup of the Prodigy-Duraloc combination in primary cementless total hip arthroplasties showed the Prodigy stem had similarly good clinical results compared with its predecessor, the AML stem, and the Duraloc cup was superior to its first-generation predecessor, the anatomic medullary locking cup with Acetabular Cup System (ACS) liner.

Adult↗

Total hip arthroplasty in patients 50 years and younger.

Because the young patient with a total hip arthroplasty is presumed to place increased demands on a reconstruction for a longer period than the average patient with a hip replacement, long-term results are expected to be inferior. To determine the efficacy of total hip replacements in this population, the current authors reviewed the long-term results of patients who were 50 years and younger who had cementless total hip arthroplasties at their institution, and reviewed the literature on total hip arthroplasty in younger patients. The results from the study population and the literature were encouraging. At the author's institute, during the past 20 years, 561 hip replacements were done on 488 patients in this age group, using extensively porous-coated cobalt-chromium stems matched with beaded, press-fit acetabular components of cobalt-chrome or titanium. Using the Kaplan-Meier technique, the survival rates for femoral and acetabular components, using any revision as an end point, were 89% at 10-year followup and 60% at 15-year followup. A subset of the authors' patients who were 40 years and younger (256 hips, 223 patients) had slightly inferior results, with 85% 10-year survivorship and 54% 15-year survivorship, using any revision as an end point. A comprehensive literature review also showed that long-term success can be achieved with cemented or cementless total hip arthroplasties in young patients. Because some reconstructions exhibited inferior results in younger patients, the authors recommend that surgeons be much more critical of the components used in these patients and allow long-term data to guide their decisions.

Adolescent↗