Abstract
Commonly total hip arthroplasty is performed on displaced femoral neck fractures of rheumatoid patients, but recently there have been several reports indicating that bipolar hemiarthroplasty is effective in rheumatoid patients with normal hips. In this study, four patients with rheumatoid arthritis and displaced femoral neck fractures were treated with primary bipolar hip arthroplasty in our hospital between 1998 and 2006, and were evaluated with respect to migration of the outer head by radiographic measurements and by the clinical scoring system of the Japanese Orthopaedics Association (JOA), especially for pain scores. Their average age and duration of RA were 66.8 (range 61-72) years and 25.8 (range 8-44) years. The average follow-up period was 5.8 (range 4-8) years. Three (75%) of the 4 hips had no radiographic evidence of migration, and in only one hip (25%), proximal migration of 4mm was noted. The JOA score was over 30/40 points in all patients. Our results also suggest that bipolar hemiarthroplasty for displaced femoral neck fractures in the normal hips of rheumatoid patients may prove to be the procedure of choice.
