Chandler et al. followed 29 patients (33 hips) under age 30 who underwent cemented total hip replacement between 1970–1972. The study asks whether the promising ten-month results would hold at five years, and whether preoperative factors could predict failure. This is one of the earliest systematic reports of THA outcomes in very young patients.
In 1981, operating on a 23-year-old with AVN felt justified by short-term data — early THA series in young patients showed nearly universal good results at under one year. Chandler's five-year data shattered that optimism and established that young patients would very likely outlive their implants.
When you see a patient under 30 needing hip reconstruction, this paper is why you should exhaust joint-preserving options first. For unilateral disease in an active young patient, arthrodesis with preservation of the abductors (enabling future THA conversion) remains a defensible choice the authors explicitly recommended. High preoperative risk scores (AVN, heavy activity, prior acetabular surgery, unilateral disease) should intensify that conversation.
The radiolucency warning is clinically actionable: a Harris Hip Score that looks good does not exclude impending failure. Progressive radiolucent lines widening beyond 2.5 mm demand close surveillance regardless of patient symptoms, because all such hips in this series eventually required revision.
Chandler et al. followed 29 patients (33 hips) under age 30 who underwent cemented total hip replacement between 1970–1972. The study asks whether the promising ten-month results would hold at five years, and whether preoperative factors could predict failure. This is one of the earliest systematic reports of THA outcomes in very young patients.
In 1981, operating on a 23-year-old with AVN felt justified by short-term data — early THA series in young patients showed nearly universal good results at under one year. Chandler's five-year data shattered that optimism and established that young patients would very likely outlive their implants.
When you see a patient under 30 needing hip reconstruction, this paper is why you should exhaust joint-preserving options first. For unilateral disease in an active young patient, arthrodesis with preservation of the abductors (enabling future THA conversion) remains a defensible choice the authors explicitly recommended. High preoperative risk scores (AVN, heavy activity, prior acetabular surgery, unilateral disease) should intensify that conversation.
The radiolucency warning is clinically actionable: a Harris Hip Score that looks good does not exclude impending failure. Progressive radiolucent lines widening beyond 2.5 mm demand close surveillance regardless of patient symptoms, because all such hips in this series eventually required revision.