Total hip replacement in adolescents.

Total hip arthroplasty in adolescents is rare but increasingly performed due to advances in implant technology. The indications differ from adults and are primarily osteonecrosis, secondary osteoarthritis or residual deformities from pediatric hip diseases, such as developmental dysplasia of the hip or slipped capital femoral epiphysis. Anatomical challenges, smaller implant sizes and prior surgery demand careful preoperative planning with advanced imaging. Modern uncemented implants and enhanced wear-resistant articulations, such as ceramic-on-ceramic (CoC) or ceramic-on-highly cross-linked polyethylene (HXLPE) have shown promising durability. While complication rates are comparable to adults, the nature of complications differs, with higher revision rates due to activity levels and anatomical complexity. Standard outcome measurements often show ceiling effects and may not reflect adolescent-specific demands. Long-term data and age-adapted assessment tools are needed to optimize outcomes in this special patient group.