FP12.3 The End of the Road: Radiographic Outcomes after THA in Adolescent Patients with an Open Triradiate Cartilage

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ID: 330956
2026
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Abstract
Abstract ICLA12 - The Chondral Masterclass: Advanced Scaffolds, Orthobiologic Realities, and Young THA, Auditorium B (BMCC Level 1), October 9, 2026, 10:30 - 12:30 Introduction Total hip arthroplasty (THA) in patients with open triradiate cartilage is rare, but results in good midterm survivorship and clinical outcomes in failed hip preservation adolescents. Currently, there is limited literature evaluating the potential impact of THA on further acetabular and pelvic growth, and common radiographic parameters in the setting of an open triradiate cartilage. Our primary aim was to assess the acetabular component position at midterm follow up after THA in skeletally immature patients with open triradiate cartilage. Our secondary aim was to report midterm radiographic and clinical outcomes, including leg length and offset, after THA in patients with open triradiate cartilage. Methods Our institutional Total Joint Registry was queried to identify 24 THAs (23 patients) with an open triradiate cartilage at the time of index operation between 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. Acetabular component inclination and version, leg lengths, and femoral and acetabular offset were measured on anteroposterior and cross table lateral radiographs immediately postoperatively and at final follow-up. The final cohort for radiographic analysis included 20 THAs (17 patients) with a mean age of 14 years and 55% male. Patients had a mean BMI of 26 kg/m2 and mean modified Oxford bone age score of 21.6. Mean follow up with radiographs was 5.7 years (median=4.9, SD=3.8). Results The indications for THA were avascular necrosis (70%), secondary arthritis (25%), and neoplasia (5%). Acetabular component inclination (Mean change in inclination 0.91°, 95% CI inclination [-4.4, 2.7], p=0.61) and acetabular component version (Mean change in anteversion -2.8°, 95% CI [-3.3, 8.9], p=0.35) did not change from immediately postoperatively to final follow-up. Similarly, there was no change in leg length (Mean change in leg length -0.5mm, 95% CI [-2.0, 5.0], p=0.38) at final follow-up. There was one revision for acetabular component loosening and no separate reoperations. The survivorships free of revision and reoperation were 95%, respectively. Conclusion Acetabular component version and inclination remain unchanged following THA performed in skeletally immature patients with open triradiate cartilage. Survivorship free of revision was excellent at 95% in mid-term follow up of 6 years. These findings suggest that THA is safe and durable in skeletally immature patients with minimal risk of implant positional change or significant leg length discrepancy during final skeletal maturation.
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Authors Zachary C. Reuter, Nicolas A. Selemon, Emil Varas‐Rodríguez, Robert T. Trousdale, Rafael J. Sierra, Emmanouil Grigoriou
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Journal Journal of hip preservation surgery
Year 2026
DOI
10.1093/jhps/hnag043.091
URL
https://doi.org/10.1093/jhps/hnag043.091
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