Total Hip Arthroplasty for Avascular Necrosis of the Femur in Systemic Lupus Erythematosus

Hm, Prupas; Patzakis, Michael J.; Fp, Quismorio

doi:10.1097/00003086-198111000-00021

Cited by 23 publications

(4 citation statements)

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“…[1][2][3][4][5][6][7][8] Although there are isolated reports of AVN occurring in patients who have not received corticosteroid therapy, in most cases this complication has developed in patients who have received hiih dose corticosteroids at some stage of the disease. It has not been established whether it is a high daily dose or the total dose which increases the risk of AVN.…”

mentioning

confidence: 99%

Early treatment of avascular necrosis in systemic lupus erythematosus.

Kalla¹,

Learmonth²,

Klemp³

1986

Annals of the Rheumatic Diseases

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mentioning

confidence: 99%

Early treatment of avascular necrosis in systemic lupus erythematosus.

Kalla¹,

Learmonth²,

Klemp³

1986

Annals of the Rheumatic Diseases

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“…Prupas et al reported good short-term results of six THAs without complications at 23 to 76 months' follow-up. 19 Chen et al also reported good short-term results of 20 THAs in 12 patients with an average follow-up of 38 months. 21 Hanssen et al reported short-to mediumterm results of 14 bipolar hemiarthroplasties and 29 THAs in 31patients with an average follow-up of 57 months.…”

Section: Discussionmentioning

confidence: 93%

“…[16][17][18] There are few reported short to mediumterm results of prosthetic hip arthroplasty in SLE or ofHRQOL in SLE after hip arthroplasty. [19][20][21][22][23][24] Zangger et al reported an average Short Form 36 (SF-36) score 25 of 63.4 after a mean follow-up of four years in 19 SLE patients with hip arthroplasty. 24 To date, the HRQOL of SLE patients with hip arthroplasty after medium to long-term follow-up has not been reported.…”

Section: Introductionmentioning

confidence: 99%

Health-related quality of life in patients with systemic lupus erythematosus after medium to long-term follow-up of hip arthroplasty

Ito

Matsuno

Hirayama

et al. 2007

Lupus

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Health-related quality of life (HRQOL) of systemic lupus erythematosus (SLE) patients with hip arthroplasty after medium to long-term follow-up has not been reported. We conducted a retrospective study for SLE patients with osteonecrosis of the femoral head (ONF). Forty-seven consecutive arthroplasties were performed in 36 patients. Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Medical Outcome Survey Short Form 36 (SF-36) and Harris hip score were evaluated. Two patients died before the four-year follow-up and two patients were lost to follow-up. The remaining 43 hips in 32 patients with an average age at surgery of 35 years and an average follow-up of 12.0 years (range 4.0-25.0) were assessed. Bipolar hemiarthroplasty was performed for 18 hips in 12 patients, and total hip arthroplasty (THA) was performed for 25 hips in 20 patients. The mean WOMAC scores for pain and function at the recent followup were 90.8 +/- 8.5points and 79.0 +/- 18.3 points. Patients with THA had significantly high scores in SF-36 physical functioning (P < 0.05) and bodily pain (P < 0.03) compared to those with bipolar hemiarthroplasty. Although improvement could not reach the level of general population, the hip arthroplasty contributed to support HRQOL of SLE patients.

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“…However, there were also studies that reported no infections in patients with SLE. 16,23,30 These different results reflect the heterogeneity of the SLE disease. Interestingly, one "big data" study 6 and one systematic review 15 found that patients with SLE undergoing THA for ONFH experienced decreased rates of infection compared with THA for osteoarthritis.…”

Section: Discussionmentioning

confidence: 97%

Performing a Safe and Effective Total Hip Arthroplasty on Patients With Inactive or Stably Active Systemic Lupus Erythematosus With Osteonecrosis

Zhang

Chen

et al. 2021

J Am Acad Orthop Surg

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Introduction: Patients with systemic lupus erythematosus (SLE) are typically treated with total hip arthroplasty (THA) because of osteonecrosis of the femoral head (ONFH). This study evaluated the outcome of THA in this patient group. Methods: From January 2004 to January 2017, we retrospectively studied 92 THAs for patients with SLE and 92 THAs for age- and sex-matched patients suffering from ONFH due to nonrheumatic etiologies Both groups were treated with cementless THA and followed up for an average of 50.9 ± 30.6 months. Their surgical outcomes and complications were evaluated and compared. Results: No significant difference existed in age, sex, weight, height, follow-up time, and Ficat staging between the groups. All patients with SLE were in inactive or stably active disease conditions. For all patients, the Harris hip score (HHS) (from 52.6 to 92.8; P < 0.001), Physical Component Summary Scale score (PCS) (from 29.4 to 49.3; P < 0.001), and Mmental Component Summary Scale score (MCS) (from 50.5 to 55.5; P < 0.001) of the Short Form-12 improved significantly after surgery. At the final follow-up, the HHS and MCS were comparable between the two groups. The PCS remained lower in the SLE group (P = 0.017), and no recorded revision surgieries in either group. Corticosteroid intake and testing positive for antiphospholipid antibodies, rather than having a SLE disease activity index score greater than zero, were risk factors for higher complications. Discussion: Performing THA for patients with SLE in an inactive or stably active disease condition resulted in comparable postoperative HHS and MCS scores, a lower PCS score, and shorter term postoperative complications compared with patients with ONFH resulting from nonrheumatic diseases. Patients with SLE had a higher risk for postoperative complications. It is generally safe and effective to perform THA in patients with inactive or stably active SLE. However, they still have an increased risk of short-term complications.

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Total Hip Arthroplasty for Avascular Necrosis of the Femur in Systemic Lupus Erythematosus

Cited by 23 publications

References 0 publications

Early treatment of avascular necrosis in systemic lupus erythematosus.

Early treatment of avascular necrosis in systemic lupus erythematosus.

Health-related quality of life in patients with systemic lupus erythematosus after medium to long-term follow-up of hip arthroplasty

Performing a Safe and Effective Total Hip Arthroplasty on Patients With Inactive or Stably Active Systemic Lupus Erythematosus With Osteonecrosis

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