Total Hip Arthroplasty in the Paediatric Population—A Systematic Review of Current Outcomes

End-stage hip joint degeneration in the paediatric population is uncommon. Traditionally, arthroplasty has had limited use in this population, owing to fears about wear and early multiple revisions. Advances in implant and bearing surface design, alongside improved surgical technique, are making total hip arthroplasty (THA) in the paediatric population a more viable option. A systematic review of THA in the paediatric population using conventional literature databases and grey literature was undertaken from January 1988 until December 2020 to determine the functional, clinical and radiological outcomes of THA in patients under 18 years old. One hundred and eighty-six studies were initially eligible from the inclusion criteria. Upon screening the papers, ten papers met the inclusion criteria and were included in the review. Heterogeneous data was acquired; therefore, no meta-analysis was performed. Overall implant survival was 96% at 5 years and equivalent to THA in adults. Functional and pain scores were significantly improved at 6 weeks, 6 months and 1-year post-operative follow-up. Complication rate was 3%. Dislocation rate was lower than adult THA at 0.4%. THA is a well-proven treatment in adults. However, this review of the literature demonstrates that THA in the paediatric population has good survival rates, with low dislocation, infection and complication rates. THA can confer significant improvements in pain and function and should be considered as a feasible option for management of end-stage degenerative disease. A prospective controlled trial is required to fully confirm and quantify this further.