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MODERN RHEUMATOLOGY Vol.12 No.3

>MR12-3

Total hip arthroplasty with bone graft for acetabular protrusion in rheumatoid arthritis
K. Kondo A1, T. Asai A1, M. Tsukamoto A1
(1) Department of Orthopedic Surgery and Rheumatology, Nagoya National Hospital, 4-1-1 San-nomaru, Naka-ku, Nagoya 460-0001, Japan
 
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Abstract
Abstract Twenty-five hips in 19 rheumatoid arthritis (RA) patients with protrusio acetabuli were followed up, both clinically and radiographically, for more than 9 years after total hip arthroplasty (THA), that was performed with a bone graft to reinforce the medial acetabular wall. Radiographs were taken preoperatively and every 6 months postoperatively. Clinical assessments of pain, gait, and range of motion of the hips were obtained preoperatively and every year postoperatively using the Japanese Orthopaedic Association hip-scoring system. Radiographs showed that bony union had occurred in all cases. Six acetabular components were loose, but no femoral components became loose during the 9-year period. The clinical evaluation showed that relief of pain was very significant. The range of motion of the hip joints also improved from 12 points to 16.6 points after 9 years. Walking ability improved, but is becoming worse as time goes by. The radiographic results were compared with the results of a THA group with RA that had not had a bone graft. The rate of loosening of the THA without a bone graft was significantly higher than that of THA with a bone graft. We concluded that bone grafting for protrusio acetabuli was a very useful procedure.
 
Key words
Key words Acetabular protrusion ・ Bone graft ・ Rheumatoid arthritis (RA) ・ Total hip arthroplasty (THA)
 
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