Total Hip Arthroplasty in Patients With Open Triradiate Cartilage: 10-Year Follow-Up of an Expanded Cohort.
case_series · Level IV
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- Also identified by DOI 10.1097/BPO.0000000000003399.
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Abstract
Total hip arthroplasty (THA) in patients with open triradiate cartilage remains controversial, with an open triradiate cartilage considered a challenge for acetabular component fixation. We previously reported excellent 5-year functional outcomes and implant survivorship in a series of patients undergoing THA with open triradiate cartilage. The current study expands this cohort to 10-year radiographic and functional outcomes. Our institutional Total Joint Registry was queried to identify 24 patients who underwent THA with an open triradiate cartilage between the years 2000 and 2024. Skeletal maturity was assessed utilizing the modified Oxford bone age, with only triradiate scores of 1 and 2 included. Demographic, implant, and radiographic data were collected. Functional outcomes were assessed through the Harris Hip score (HHS). The previously analyzed cohort (11 patients, 12 THAs) had a mean age of 13 years, and a mean follow-up of 10 years (range: 5 to 15). The overall expanded cohort (24 THAs) had a mean age of 14 years, with a mean follow-up of 6 years (range: 1 to 15) and a mean modified Oxford bone age was 22. The most common indications for THA were avascular necrosis ( 67%), secondary arthritis (25%), and neoplasia (8%). Preoperatively, 54% of patients utilized gait aids; at final follow-up, all patients reported independent ambulation with a mean HHS of 92. Radiographically, 92% of implants showed stable osseointegration at the latest follow-up. Two patients required acetabular component revisions for aseptic loosening, one of whom required rerevision for instability. The present study expands on the largest series in the literature of THA in patients with open triradiate cartilage. Our results demonstrate excellent functional outcomes, 92% implant survivorship, and low complication rates at long-term 10-year follow-up. These findings suggest THA is safe and durable in patients with open triradiate cartilage without the need to delay arthroplasty for closure of the triradiate cartilage. Level III.