抄録
Objective: Total hip arthroplasty (THA) in patients with rheumatoid arthritis (RA) is considered a way to relieve pain and reconstruct the articular function of the hip joint. Previously, cemented THA was considered the gold-standard procedure for such a patient population; however, several authors have recently demonstrated excellent mid-term results with uncemented THA in RA patients. Currently, it is still controversial which procedure is more appropriate for this patient population. In this study, we evaluate the efficacy and safety of uncemented THA in patients with RA.
Methods: In our institute, 60 uncemented THAs in 47 patients with RA were carried out from January 1990 to December 2000. Of these 60 THAs, 31 THAs (23 patients) were lost to follow up, and the remaining 29 THAs (24 patients) were included in this study. The mean age at surgery was 51.3 years; the mean follow-up period after surgery was 12.3 years (minimum 10 years). We evaluated the clinical results (in terms of JOA score) and radiographic findings.
Results: One THA had been revised for aseptic loosening of the acetabular component 8 years after primary surgery. The mean JOA score of the remaining 28 THAs was significantly improved at 70.1 points from 38.7 points preoperatively. In radiographs, the fixations of the acetabular component were stable in 18 THAs and possibly stable in 10 according to Tompkins criteria; the biological fixations of the femoral components were considered bone ingrowth fixation in 27 THAs and fibrous stable fixation in 1, according to Engh’s criteria. Nonprogressive subsidence of the femoral component was observed in 7 THAs.
Conclusion: In this study, we demonstrated satisfactory long-term (minimum 10 years) results of uncemented THA for patients with RA. We consider that uncemented THA is a promising candidate for such a patient population.
