Background: Total hip arthroplasty (THA) is a commonly utilized surgical method to alleviate pain and improve function in advanced-stage hip osteoarthritis. Although it is predominantly used in elderly individuals with lower functional levels, THA is increasingly preferred in younger individuals for various conditions such as inflammatory rheumatologic diseases and developmental dysplasia of the hip that lead to advanced hip degeneration. In the literature, studies on patients undergoing THA under the age of 40 predominantly focus on prosthesis design, implant longevity, and the need for revision. However, for younger patients undergoing THA, functional performance, physical and social activities, and participation are at least as important as the longevity of the prosthesis.

Objectives: The aim of the study was to compare the long-term functional outcomes of patients under 40 years of age who underwent THA with age and gender matched asymptomatic controls.

Methods: A total of 86 individuals with mean age: 41.81±10.50 years; mean BMI:26.86±20.12 kg/m ² (43 THA patients and 43 asymptomatic controls) were included this prospective study. The fear of falling and the fear of movement of the individuals were assessed using the Visual Analog Scale (VAS). The functional performance was assessed using the Timed up and Go Test (TUG) and Five Times Sit-to-Stand test (5TSTS). All study participants were asked to complete the hip related patients reported outcome scores including Hip disability and Osteoarthritis Outcome Score (HOOS), Oxford Hip Score (OHS), Harris Hip Score (HHS) and health related quality of life scale (SF-12).

Results: Patients in the THA group had an average postoperative duration of 11.00±5.14 years and 68.4 % (29 patients) had unilateral THA while 32.6 % (14 patients) had bilateral THA. Etiology of hip disease in the THA group was most commonly developmental dysplasia (34.9%), inflammatory arthritis (27.9%), avascular necrosis (23.3%), and other disease (13.9%). Demographic information displays no difference between the groups (Table 1). The hip related patients reported outcomes (p<0.001), functional performance (p<0.001), pain scores (p=0.013) and SF-12 physical health subscore (p=0.003) showed statistically difference between the groups whereas the SF-12 mental health subscore showed no difference (p>0,05) (Table 2). The fear of falling and fear of movement also showed statically difference between groups (p<0.001) (Table 2).

Conclusion: The findings of this study reveal that patients under 40 years of age undergoing THA do not achieve the same levels of physical function and functional performance compared to their age and gender matched asymptomatic controls. Moreover, although a significant improvement in pain and quality of life are achieved following THA in younger ages, long-term attention should also be directed toward patients’ physical function, functional performance, and fear-related behaviors. Since the fear of falling and fear of movement were found to be persistent for long-term after surgery, rehabilitation programs should also include these parameters from the beginning of the postoperative rehabilitation.

REFERENCES: [1] Skyttä ET, Jarkko L, Antti E, Huhtala H, Ville R. Increasing incidence of hip arthroplasty for primary osteoarthritis in 30-to 59-year-old patients: a population based study from the Finnish Arthroplasty Register. Acta orthopaedica. 2011;82(1):1-5.

[2] de Kam DC, Gardeniers JW, Veth RP, Schreurs BW. Good results with cemented total hip arthroplasty in patients between 40 and 50 years of age: 168 hips followed for 2–19 years. Acta orthopaedica. 2010;81(2):165-70.

[3] Walker RP, Gee M, Wong F, Shah Z, George M, Bankes MJ, et al. Functional outcomes of total hip arthroplasty in patients aged 30 years or less: a systematic review and meta-analysis. Hip International. 2016;26(5):424-31.

[4] Konopitski A, Okafor C, Smith B, Baldwin K, Sheth NP. Evolution of total hip arthroplasty in patients younger than 30 years of age: A systematic review and meta-analysis. Archives of Orthopaedic and Trauma Surgery. 2023;143(2):1081-94.

Acknowledgements: None declared.

Disclosure of Interests: None declared.

© The Authors 2025. This abstract is an open access article published in Annals of Rheumatic Diseases under the CC BY-NC-ND license ( http://creativecommons.org/licenses/by-nc-nd/4.0/ ). Neither EULAR nor the publisher make any representation as to the accuracy of the content. The authors are solely responsible for the content in their abstract including accuracy of the facts, statements, results, conclusion, citing resources etc.