PDF
ePub
Citation
Print
Abstract
Objective
This study analyzed the midterm results of hip resurfacing arthroplasty in patients with rheumatoid arthritis.
Methods
Between October of 2003 and September of 2008, 13 consecutive hips that were treated with hip resurfacing arthroplasty due to rheumatoid arthritis were analyzed. The average follow up period was 48.6 months and the mean age at the time of operation was 35.9 years old. The mean BMI at the operation was 23.2 kg/m2. The implanted prostheses were the Conserve Plus system in five hips, the Birmingham hip resurfacing system in four hips and the Durom system in four hips. The results were clinically evaluated with the Harris hip score, the UCLA activity score, hip or thigh pain, the limb length discrepancy and the range of motion. As radiological evaluation, we observed the patterns of bone remodeling and complications such as femoral neck fracture, loosening and osteolysis.
Results
The average Harris hip score improved from 62.2 to 98.9 at the final visit. The range of motion improved to 0 o in flexion contracture, 118.1 o in further flexion, 22.7 o in internal rotation, 40.4 o in external rotation, 28.8 o in adduction and 38.1 o in abduction, respectively. No patient complained of a limb length discrepancy and hip or thigh pain. Radiographically, impingement between the ace-tabular component and the femoral neck was observed in one case. However, radiographic findings such as osteol-ysis, radiolucency, wear and loosening were not observed.
References
1. Doran MF, Crowson CS, Pond GR, O'Fallon WM, Gabriel SE. Frequency of infection in patients with rheumatoid arthritis compared with controls: a populati-on-based study. Arthritis Rheum. 2002; 46:2287–93.
2. Bernatsky S, Hudson M, Suissa S. Antirheumatic drug use and risk of serious infections in rheumatoid arthritis. Rheumatology (Oxford). 2007; 46:1157–60.
3. Creighton MG, Callaghan JJ, Olejniczak JP, Johnston RC. Total hip arthroplasty with cement in patients who have rheumatoid arthritis. A minimum ten-year followup study. J Bone Joint Surg Am. 1998; 80:1439–46.
4. Schmalzried TP, Peters PC, Maurer BT, Bragdon CR, Harris WH. Long-duration metal-on-metal total hip ar-throplasties with low wear of the articulating surfaces. J Arthroplasty. 1996; 11:322–31.
5. Lipsky PE, van der Heijde DM, St Clair EW, Furst DE, Breedveld FC, Kalden JR, et al. Antitumor Necrosis Factor Trial in Rheumatoid Arthritis with Concomitant Therapy Study Group. Infliximab and methotrexate in the treatment of rheumatoid arthritis. Antitumor Necrosis Factor Trial in Rheumatoid Arthritis with Concomitant Therapy Study Group. N Engl J Med. 2000; 343:1594–602.
6. Klareskog L, van der Heijde D, de Jager JP, Gough A, Kalden J, Malaise M, et al. TEMPO (Trial of Etanercept and Methotrexate with Radiographic Patient Outcomes) study investigators. Therapeutic effect of the combination of etanercept and methotrexate compared with each treatment alone in patients with rheumatoid arthritis: double-blind randomised controlled trial. Lancet. 2004; 363:675–81.
7. Kapetanovic MC, Lindqvist E, Saxne T, Eberhardt K. Orthopaedic surgery in patients with rheumatoid arthritis over 20 years: prevalence and predictive factors of large joint replacement. Ann Rheum Dis. 2008; 67:1412–6.
8. da Silva E, Doran MF, Crowson CS, O'Fallon WM, Matteson EL. Declining use of orthopedic surgery in patients with rheumatoid arthritis? Results of a longterm, population-based assessment. Arthritis Rheum. 2003; 49:216–20.
9. Wolfe F, Zwillich SH. The longterm outcomes of rheumatoid arthritis: a 23-year prospective, longitudinal study of total joint replacement and its predictors in 1,600 patients with rheumatoid arthritis. Arthritis Rheum. 1998; 41:1072–82.
10. Cracchiolo A 3rd, Severt R, Moreland J. Uncemented total hip arthroplasty in rheumatoid arthritis diseases. A two- to six-year followup study. Clin Orthop Relat Res. 1992; (277):166–74.
11. Kirk PG, Rorabeck CH, Bourne RB, Burkart B. Total hip arthroplasty in rheumatoid arthritis: comparison of cemented and uncemented implants. Can J Surg. 1993; 36:229–32.
12. Unger AS, Inglis AE, Ranawat CS, Johanson NA. Total hip arthroplasty in rheumatoid arthritis. A longterm followup study. J Arthroplasty. 1987; 2:191–7.
13. Kitsoulis PB, Stafilas KS, Siamopoulou A, Soucacos PN, Xenakis TA. Total hip arthroplasty in children with juvenile chronic arthritis: longterm results. J Pediatr Orthop. 2006; 26:8–12.
14. Poss R, Maloney JP, Ewald FC, Thomas WH, Batte NJ, Hartness C, et al. Six- to 11-year results of total hip arthroplasty in rheumatoid arthritis. Clin Orthop Relat Res. 1984; (182):109–16.
15. Chmell MJ, Scott RD, Thomas WH, Sledge CB. Total hip arthroplasty with cement for juvenile rheumatoid arthritis. Results at a minimum of ten years in patients less than thirty years old. J Bone Joint Surg Am. 1997; 79:44–52.
16. Bongartz T, Sutton AJ, Sweeting MJ, Buchan I, Matteson EL, Montori V. Anti-TNF antibody therapy in rheumatoid arthritis and the risk of serious infections and malignancies: systematic review and meta-analysis of rare harmful effects in randomized controlled trials. JAMA. 2006; 295:2275–85.
17. Charnley J. Arthroplasty of the hip. A new operation. Lancet. 1961; 1:1129–32.
18. Amstutz HC, Graff-Radford A, Gruen TA, Clarke IC. THARIES surface replacements: a review of the first 100 cases. Clin Orthop Relat Res. 1978; (134):87–101.
19. Furuya K, Tsuchiya M, Kawachi S. Socket-cup arthroplasty. Clin Orthop Relat Res. 1978; (134):41–4.
20. Wagner H. Surface replacement arthroplasty of the hip. Clin Orthop Relat Res. 1978; (134):102–30.
21. August AC, Aldam CH, Pynsent PB. The McKee-Farrar hip arthroplasty. A longterm study. J Bone Joint Surg Br. 1986; 68:520–7.
22. Visuri T. Longterm results and survivorship of the McKee-Farrar total hip prosthesis. Arch Orthop Trauma Surg. 1987; 106:368–74.
23. McMinn D, Treacy R, Lin K, Pynsent P. Metal on metal surface replacement of the hip. Experience of the McMinn prothesis. Clin Orthop Relat Res. 1996; (329 Suppl):S89–98.
24. Ali Khan MA, Brakenbury PH, Reynolds IS. Dislocation following total hip replacement. J Bone Joint Surg Br. 1981; 63-B:214–8.
25. Woo RY, Morrey BF. Dislocations after total hip arthroplasty. J Bone Joint Surg Am. 1982; 64:1295–306.
26. Daniel J, Pynsent PB, McMinn DJ. Metal-on-metal resurfacing of the hip in patients under the age of 55 years with osteoarthritis. J Bone Joint Surg Br. 2004; 86:177–84.
27. Shimmin AJ, Bare J, Back DL. Complications associated with hip resurfacing arthroplasty. Orthop Clin North Am. 2005; 36:187–93.
28. Amstutz HC, Antoniades JT, Le Duff MJ. Results of metal-on-metal hybrid hip resurfacing for Crowe type-I and II developmental dysplasia. J Bone Joint Surg Am. 2007; 89:339–46.
29. Nishii T, Sugano N, Miki H, Takao M, Koyama T, Yoshikawa H. Five-year results of metal-on-metal resurfacing arthroplasty in Asian patients. J Arthroplasty. 2007; 22:176–83.
30. Garvin KL, Hanssen AD. Infection after total hip arthroplasty. Past, present, and future. J Bone Joint Surg Am. 1995; 77:1576–88.
31. Amstutz HC, Graff-Radford A, Mai LL, Thomas BJ. Surface replacement of the hip with the Tharies system. Two to five-year results. J Bone Joint Surg Am. 1981; 63:1069–77.
32. Archibeck MJ, Berger RA, Jacobs JJ, Quigley LR, Gitelis S, Rosenberg AG, et al. Second-generation ce-mentless total hip arthroplasty. Eight to eleven-year results. J Bone Joint Surg Am. 2001; 83-A:1666–73.
33. Sinha RK, Dungy DS, Yeon HB. Primary total hip arthroplasty with a proximally porous-coated femoral stem. J Bone Joint Surg Am. 2004; 86-A:1254–61.
34. Yoo MC, Cho YJ, Kim KI, Chun SW, Park KJ, Park SW. Changes in BMD in the proximal femur after ce-mentless total hip arthroplasty and resurfacing arthroplasty: prospective, longitudinal, comparative Study. J Korean Orthop Assoc. 2006; 41:212–9.
35. Le Duff MJ, Wisk LE, Amstutz HC. Range of motion after stemmed total hip arthroplasty and hip resurfacing - a clinical study. Bull NYU Hosp Jt Dis. 2009; 67:177–81.
36. Marker DR, Seyler TM, Jinnah RH, Delanois RE, Ulrich SD, Mont MA. Femoral neck fractures after met-al-on-metal total hip resurfacing: a prospective cohort study. J Arthroplasty. 2007; 22(7 Suppl 3):66–71.
37. Amstutz HC, Campbell PA, Le Duff MJ. Fracture of the neck of the femur after surface arthroplasty of the hip. J Bone Joint Surg Am. 2004; 86-A:1874–7.
Figure 1.
Pictures of the current used Hip resurfacing systems. (A) Conserve Plus system (Wright Medical Technology, Arlington, TN, USA), (B) Birmingham hip resurfacing system (Midland Medical Technologies, Birmingham, UK), (C) Durom system (Zimmer, Warsaw, IN, USA).
Figure 2.
(A) The anteroposterior radiograph shows severe destruction of both hip joint of 34 years old female with rheumatoid arthritis. (B) The radiograph taken 4 years after surgery, shows excel-lent alignment of the inserted implants and no evidence of osteo-lysis and loosening in the same patient.
Table 1.
Clinical data of the range of motion
XML Download