Primary total hip arthroplasty in patients with rheumatoid arthritis

Abstract

Twenty-eight (11 cemented and 17 noncemented) total hip arthroplasties (THA) were performed in 20 patients with rheumatoid arthritis (RA). The average age at operation was 42.1 years and the average follow-up was 10.8 years. There were two deep infections requiring removal of the prosthesis. Three cemented acetabular cups and one cemented femoral component were revised due to aseptic loosening. One cemented cup was loosened radiologically. One PCA polyethylene liner was revised because of significant wear. Both cemented and noncemented femoral components are capable of providing respectable results in RA patients. The relatively inferior results of THA among RA patients is due not only to the fixation method, but also to the poorer bone quality.Résumé Vingt-huit arthroplasties totales de hanche (11 cimentées, 17 non-cimentées) ont été exécutées sur 20 malades atteints de polyarthrite rhumato. L'âge moyen à l'opération était de 42,1 ans et la durée moyenne de suivi de 10,8 années. Deux infections profondes ont nécessité l'ablation de la prothèse. Trois composants cotyloidiens cimentés et un composant fémoral cimenté ont été révisé à cause d'un descellement aseptique. Un composant cotyloidien montre un descellement radiographique. Un insert de polyéthylène a été remplacé à cause d'une usure notable. Les composants fémoraux cimentés et noncimentés ont la capacité de fournir un résultat acceptable dans le cas d'une polyarthrite rhumato. Les résultats relativement inférieurs des prothèses totales chez ces malades proviennent non seulement de la méthode de fixation mais aussi d'une mauvaise qualité osseuse.

An Insight into Methods and Practices in Hip Arthroplasty in Patients with Rheumatoid Arthritis

“…Furthermore, the rate of requirement of revision surgery and implant survival was not significantly different. The use of uncemented HA-coated prosthesis [ 42 ] and porous prosthesis [ 33 ], in short-term studies, has generated promising results [ 43 ]. In more recent years, the use of porous-coated stems and cemented all-polyethylene cups has been recommended as implants of choice in young patients with RA [ 44 ].…”

Hip and Knee Arthroplasty in the Patient with Inflammatory Arthritis

“…Functional outcomes following THA are poorer in rheumatoid compared with non-inflammatory arthritis [73], this is perhaps explained by the multiple joints involvement in this group and its effects on functional outcomes [115]. Nevertheless, following THA in 50 rheumatoid patients, Harris hip score improved from 22 to 82 at 9 years mean follow up [116], and from 25 to 89 at 11 years follow up in another cohort of 20 patients [117].…”

Otsenka dinamiki mineral'noy plotnosti kostnoy tkani vokrug endoproteza posle operatsii total'nogo bestsementnogo endoprotezirovaniya tazobedrennogo sustava u bol'nykh s revmaticheskimi zabolevaniyami

“…В области бедренного компо-нента протеза измеряли величину МПК в 7 зонах, описанных Т.А.Gruen и соавт. [14], в области вертлуж-ного компонента -в 3 зонах, описанных J.D. DeLee и J. Charnley [15] (см.…”