BackgroundTotal hip arthroplasty (THA) is an effective procedure, commonly performed following osteoarthritis in those over 70 years of age.In younger patients who have a longer life expectancy and higher functional demands, often with heterogeneous and complex hip disorders, it raises concerns about durability, complications, and follow-up care.Yet population-level data on this subgroup remains limited. MethodsWe conducted a nationwide cohort study using the French national hospital database (PMSI) from 2010 to 2023.All patients undergoing primary THA were included and compared to the subgroup aged 30 years, evaluating surgical procedure types and reinterventions after the first THA.Among 1,017,320 patients who underwent primary THA, 4,416 (0.4%) were aged 30 years and were followed up on average for 5.8 years (range, 0 to 13,8).Their mean age was 24 years (range, 5 to 109) and 57% were men. ResultsCompared to the overall THA population, they more frequently underwent THA after procedures involving femoral head lowering into the acetabulum (7.5 versus 0.8%) and following fracture fixation or cervico-cephalic prosthesis (5.3 versus 1.3%).Over the follow-up period, reintervention J o u r n a l P r e -p r o o f rates were higher in this group than for the general population (8.4 versus 6.3%), with 2.7% (n = 118) for non-surgical dislocation (versus 2.0%), 4.9% (n = 216) for aseptic loosening (versus 3.5%), 2.4% (n = 106) for periprosthetic fracture (versus 2.2%), and 0.5% (n = 24) for implant removal (versus 0.3%), and those events occurred faster. ConclusionA THA is rarely performed in patients aged 30 years but seems to be associated with more complex procedures and higher complication rates than in the older general population.Given their elevated lifetime risk of reintervention, tailored surgical strategies and long-term care planning are essential to improve outcomes in this high-risk group.
Barbier et al. (2026) studied this question.