Abstract
Thirty-six operations were performed on 21 patients with systemic lupus erythematosus (SLE) from 1987 to 1996 at Okayama University Hospital. All patients had been treated with corticosteroid administration. The average age of onset of SLE was 29 years (16-56 years), and the average age at time of operations was 40 years (18-61 years) . Fifteen total hip replace ments (THR), 6 Sugioka's transtrochanteric rotational osteotomies, 5 femoral head replace ments (FHR), 2 humeral head replacements (HHR) and 2 total knee replacements (TKR) were performed for osteonecrosis. Two arthrodeses of the CM joint of the thumb were performed for Jaccoud deformity. In the cases of THR and FHR, no migration of implants were seen and the results were very satisfactory. However, the results of Sugioka's osteotomies were poor. Collapse progressed in three femoral heads and two were salvaged by THR. In one case, dislo cation of the femoral head occurred at SLE crisis. As fatal postoperative complications, pulmonary embolism in one revision THR patient and intestinal perforation in one HHR patient were seen. One patient with intestinal perforation followed by panperitonitis died of sepsis. In one TKR patient, late infection occurred and infection did not subside without removal of the prosthesis. Surgical treatment for SLE patients should not be performed without taking these results and complications into consideration.
