Arthroplasty options for the young arthritic hip

Total hip arthroplasty (THA) is a successful surgical option for the management of end stage degenerative joint disease allowing. Registry data reveals that the international trend is toward THA in an ever-younger patient population but the long-term outcomes may not be as good in this age group, with a lifetime risk of revision of 35% in patients younger than 55. The mean age at surgery, according to registry data is 68 for males and 70 for females. Patients under the age of 55 are considered young while patients under 30 are considered very young. We present a literature-based discussion of the various THA options available and consider the relative merits of each with regards to longevity, revision rate and overall outcomes in the younger patient. Cost effectiveness is also considered. Metal-on-metal hip resurfacing continues to have a place, but the use of uncemented THA with a ceramic head matched to a highly-crosslinked polyethylene or ceramic liner is safe; and offers excellent results in the majority of cases.