J Rheum Dis.  2011 Jun;18(2):79-84.

Hip Resurfacing Arthroplasty in Patients with Rheumatoid Arthritis

• Cho YJ
• Chun YS
• Kim KI
• Rhyu KH
• Yoo MC
• Hong SH

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 0degrees in flexion contracture, 118.1degrees in further flexion, 22.7degrees in internal rotation, 40.4degrees in external rotation, 28.8degrees in adduction and 38.1degrees in abduction, respectively. No patient complained of a limb length discrepancy and hip or thigh pain. Radiographically, impingement between the acetabular component and the femoral neck was observed in one case. However, radiographic findings such as osteolysis, radiolucency, wear and loosening were not observed.
CONCLUSION
The midterm results of hip resurfacing arthroplasty in patients with rheumatoid arthritis were excellent. But long-term studies are needed to determine the survivorship and to evaluate the osteoporotic change, the metal ion level and their influence after hip resurfacing arthroplasty.

Keyword

Rheumatoid arthritis; Hip resurfacing arthroplasty

MeSH Terms

Arthritis, Rheumatoid
Arthroplasty
Bone Remodeling
Contracture
Extremities
Femoral Neck Fractures
Femur Neck
Follow-Up Studies
Hip
Humans
Osteolysis
Prostheses and Implants
Range of Motion, Articular
Survival Rate
Thigh

Figure

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  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).

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  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.

Reference

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