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MR Vol.12 No.3 indexに戻る
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MODERN RHEUMATOLOGY
Vol.12 No.3 |
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Total hip arthroplasty with bone graft for acetabular
protrusion in rheumatoid arthritis |
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| 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. |
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| Key words |
| Key words Acetabular protrusion ・ Bone graft
・ Rheumatoid arthritis (RA) ・ Total hip arthroplasty (THA) |
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