Total hip arthroplasty using porous-coated femoral components in patients with rheumatoid arthritis

Abstract

W e studied the results of total hip arthroplasty (THA) using AML porous-coated femoral components at a mean follow-up of 11 years in a non-selected, consecutive series of patients with rheumatoid arthritis. We reviewed 64 patients with 82 primary THAs using these components. There were seven men (8 hips) and 57 women (74 hips) with a mean age of 55.1 years (24 to 80) at the time of surgery.Nine patients (11 hips) died before the two-year follow-up. Of the remaining 71 hips, only one stem was revised for aseptic loosening. Survivorship for the stems was 98.1% (95% confidence interval (CI) 94.5 to 100.0) at ten years, using a life-table analysis, with revision for any reason as an endpoint. Of the 70 unrevised stems, 66 (94%) had bony ingrowth, while four (6%) were radiologically loose at the most recent follow-up (mean 11.4 years). Our study shows the excellent long-term results which can be achieved with porous-coated femoral components in patients with rheumatoid arthritis.J Bone Joint Surg [Br] 2001;83-B:686-90.

A long-term follow-up of 60 Lord total hip arthroplasties in rheumatic disease: a mean follow-up of 14 years

“…The 88% survival at 15 years found in this study shows that the Lord femoral component has a rather favourable outcome in RA compared with other stem types [13,16]. Jana et al published a series of 82 THAs with a uncemented, porous-coated, anatomical medullary locking stem [7] with a 10-year survival of 98.1%. The Bi-Metric cementless stem had a survival of 97.4% at 10 years in patients with juvenile chronic arthritis [16].…”

Lésions articulaires multiples chez le sujet âgé (polyarthrite rhumatoïde)

“…L'âge et la polyarthrite ne semblent pas une contre-indication à l'utilisation d'une prothèse sans ciment dans la littérature, sur l'un, l'autre ou les deux versants de la prothèse de hanche [3], même si la plupart des publications font état de prothèses cimentées. Les polyarthritiques ont deux fois plus de risque de luxer leur prothèse de hanche, précocement ou à grande distance, ce qui pourrait pousser à l'utilisation d'emblée de prothèses de hanche à double mobilité.…”

“…C'est très réguliè-rement entre 75 et 80 ans pour une prothèse totale de hanche [3,32], et nous voyons très régulièrement des patientes de plus de 80 ans en très bonne condition physique. Peut-être sera-t-on plus circonspect pour la réalisation d'une prothèse de genou, en raison des pertes sanguines postopératoires et du risque d'accident vasculaire cérébral, les plus petits se traduisant par une désorienta-tion postopératoire transitoire.…”

Survival of primary total hip arthroplasty in rheumatoid arthritis patients

“…Some (Unger et al 1987, Snorrason et al 1993, Lachiewicz 1997, Creighton et al 1998, Jana et al 2001, Tang and Chiu 2001) but not all authors (Kirk et al 1993, Ranawat 1998, Furnes et al 2001, Eskelinen et al 2006) have reported a poor prognosis of THA in RA patients, but the findings have been inconsistent. Several design issues may have undermined the existing study results, including small study samples, lack of long-term follow-up, incomplete follow-up, and lack of control groups (e.g.…”