This 2012 narrative review by Polkowski et al. examines the indications, surgical complexity, and reported outcomes of THA in patients under 30 years old — a population with high functional demands, complex deformities, and a lifetime of implant wear ahead of them. The article synthesizes historical cemented and modern noncemented series and addresses how joint-preserving procedures should be designed with future THA conversion in mind.
When you see a patient under 30 needing THA, expect osteonecrosis or secondary OA as the cause, plan for complex deformity requiring extensile exposure, and choose press-fit noncemented fixation — cemented stems have unacceptably high revision rates in this population.
Every prior joint-preserving procedure you perform on a young hip should be executed with eventual THA conversion in mind: protect the abductors, keep hardware away from the acetabular rim, and avoid wedge osteotomy cuts that distort the femoral canal.
This 2012 narrative review by Polkowski et al. examines the indications, surgical complexity, and reported outcomes of THA in patients under 30 years old — a population with high functional demands, complex deformities, and a lifetime of implant wear ahead of them. The article synthesizes historical cemented and modern noncemented series and addresses how joint-preserving procedures should be designed with future THA conversion in mind.
When you see a patient under 30 needing THA, expect osteonecrosis or secondary OA as the cause, plan for complex deformity requiring extensile exposure, and choose press-fit noncemented fixation — cemented stems have unacceptably high revision rates in this population.
Every prior joint-preserving procedure you perform on a young hip should be executed with eventual THA conversion in mind: protect the abductors, keep hardware away from the acetabular rim, and avoid wedge osteotomy cuts that distort the femoral canal.