Abstract
Patients with rheunatoid arthritis who have bilateral hip joints ankylosis can not stand and walk unless at least one hip joint obtains its mobility. For the purpose of mobilization of the ankylosed hip joint the mold arthroplasty, prosthetic arthroplasty, or Whitmanis or Colonna's hip reconstruction has been performed.
Weight-bearing on the operated fragile hip, however, frequently results in postoperative fracture or severe pain which necessitates to make re-operation. Accordingly, it seems that mobilization by means of resection of the head or neck of the femur in bilateral hip joints ankylosis with fragile bone particularly as in rheumatoid patients is the first choice of the surgery.
We had two cases involved in bilateral hip-joints ankylosis due to rheumatoid arthritis. One was 29 years old female, the other was 28 years old female. These two patients have had to be recumbent on the bed for around 10 years.
Their bones were markedly fragile in X-ray findings with former surgery of the other joints.
The 29 years old patient had resection of the head and neck of the right femur. One and half year after the surgery, she could walk several handred meters with a Thomas' splint adapted on the operated leg using forearm crutches.
The other case had resection of the neck of the right femur, eight months thereafter, she had osteotmy in supracondylar region of the left femur to get functional position of the left knee ankylosed on flexion. In this case also, much better functional capacities in the daily life activity were obtained.
At present time, one year after the mobilization of the hip, she has been taken bed exercise, and it is expected that she will get ability of standing and walking in near future.
