抄録
We treated 9 patients (9 hips) with rapidly destructive coxarthropathy (RDC). We performed total hip arthroplasty (THA) for all cases, 1 with cementless, 3 with cemented and 5 with hybrid. The average age of the patients was 79 years (range from 73 to 85 years). The average follow-up period was 2 years 6 months (from 1 year to 6 years 4 months). The average postoperative JOA score improved from 34.3 to 81.3 points. There were no appearances of radiopaque lines, loosening, or migration on the radiographs. There were no complications.
The causes of RDC are not clear, however, it has been suggested that subchondral insufficiency fracture might play an important role in the initiation of RDC, and that the progression of RDC is accelerated by posterior pelvic tilt and bone fragilities of osteoporosis.
In general, the clinical results of THA for RDC are poorer than those of THA for osteoarthritis. We think that acetabular reconstruction is important for good long-term results because of early loosening of the socket in THA for RDC. When the degree of acetabular destruction is remarkable, we perform acetabular reconstruction using the K-T plate or cup supporter for RDC as indicated.
