MIDDLE- AND LONG-TERM EFFECTIVENESS OF PRIMARY TOTAL HIP ARTHROPLASTY FOR PATIENTS WITH CHRONIC AUTOIMMUNE INFLAMMATORY DISEASE_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

KANG Yan , ZHANG Ziji , ZHANG Zhiqi , YANG Zibo , FU Ming , SHENG Puyi , HE Aishan , XU Dongliang , LIAO Weiming.

Department of Joint Surgery, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou Guangdong, 510080, P.R.China. Corresponding author: LIAO Weiming, E-mail: liaoweiming29@163.com;

Corresponding author：

Keywords：

Total hip arthroplasty; Chronic autoimmune inflammatory disease; Joint functional reconstruction

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ObjectiveTo evaluate the middle- and long-term effectiveness of primary total hip arthroplasty (THA) in patients with chronic autoimmune inflammatory diseases. MethodsBetween January 1990 and June 2006, 42 patients (51 hips) with chronic autoimmune inflammatory diseases underwent THA. There were 15 males (18 hips) and 27 females (33 hips) with an average age of 36.9 years (range, 22-70 years). The locations were the left side in 29 hips and the right side in 22 hips. Of 42 cases, there were 11 cases of systemic lupus erythematosus (13 hips), 16 cases of rheumatoid arthritis (22 hips), and 15 cases of ankylosing spondylitis (16 hips). The causes of THA included avascular necrosis of the femoral head in 26 cases (34 hips), ankylosis of the hip in 15 cases (16 hips), and fracture of the femoral neck in 1 case (1 hip). The Harris score was 32.49 ± 9.50. The physical component summary (PCS) and mental component summary (MCS) of short form 36 health survey scale (SF-36) scores were 25.53 ± 4.46 and 42.28 ± 6.27, respectively. ResultsAll incisions healed primarily. All 42 patients were followed up 5-21 years (mean, 9.1 years). At last follow-up, the Harris score was 89.25 ± 8.47; PCS and MCS of the SF-36 were 51.35 ± 4.28 and 55.29 ± 8.31, respectively; and significant differences in the scores were found between pre- and post-operation (P lt; 0.05). Complications included limp (4 cases), prosthesis dislocation (2 cases, 2 hips), periprosthetic fracture (1 case, 1 hip), aseptic loosening (2 cases, 2 hips), and ectopic ossification (3 cases, 3 hips). ConclusionTHA seems to be a good choice for patients with chronic autoimmune inflammatory diseases.

Citation： KANG Yan,ZHANG Ziji,ZHANG Zhiqi,YANG Zibo,FU Ming,SHENG Puyi,HE Aishan,XU Dongliang,LIAO Weiming.. MIDDLE- AND LONG-TERM EFFECTIVENESS OF PRIMARY TOTAL HIP ARTHROPLASTY FOR PATIENTS WITH CHRONIC AUTOIMMUNE INFLAMMATORY DISEASE. Chinese Journal of Reparative and Reconstructive Surgery, 2012, 26(9): 1033-1036. doi: Copy

1.	Zangger P, Gladman DD, Urowitz MB, et al. Outcome of total hip replacement for avascular necrosis in systemic lupus erythematosus. J Rheumatol, 2000, 27(4): 919-923.
2.	Chong RW, Chong CS, Lai CH. Total hip arthroplasty in patients with chronic autoimmune inflammatory arthroplasties. Int J Rheum Dis, 2010, 13(3): 235-239.
3.	Pietrzak K, Strzyzewski W, Kaczmarek W, et al. Total hip replacement in treatment of patients with deformity of the hip caused by ankylosing spondylitis. Chir Narzadow Ruchu Ortop Pol, 2010, 75(5): 282-286.
4.	Keats AS. The ASA classification of physical status—a recapitulation. Anesthesiology, 1978, 49(4): 233-236.
5.	Harris WH, McCarthy JC Jr, O’ Neill DA. Femoral component loosening using contemporary techniques of femoral cement fixation. J Bone Joint Surg (Am), 1982, 64(7): 1063-1067.
6.	Engh CA, Bobyn JD, Glassman AH. Porous-coated hip replacement. The factors governing bone ingrowth, stress shielding, and clinical results. J Bone Joint Surg (Br), 1987, 69(1): 45-55.
7.	Kawamura H, Dunbar MJ, Murray P, et al. The porous coated anatomic total hip replacement. A ten to fourteen-year follow-up study of a cementless total hip arthroplasty. J Bone Joint Surg (Am), 2001, 83-A (9): 1333-1338.
8.	Engh CA, Massin P, Suthers KE. Roentgenographic assessment of the biologic fixation of porous-surfaced femoral components. Clin Orthop Relat Res, 1990, (257): 107-128.
9.	Brooker AF, Bowerman JW, Robinson RA, et al. Ectopic ossification following total hip replacement. Incidence and a method of classification. J Bone Joint Surg (Am), 1973, 55(8): 1629-1632.
10.	Zizic TM, Marcoux C, Hungerford DS, et al. Corticosteroid therapy associated with ischemic necrosis of bone in systemic lupus erythematosus. Am J Med, 1985, 79(5): 596-604.
11.	Mont MA, Glueck CJ, Pacheco IH, et al. Risk factors for osteonecrosis in systemic lupus erythematosus. J Rheumatol, 1997, 24(4): 654-662.
12.	Mok MY, Farewell VT, Isenberg DA. Risk factors for avascular necrosis of bone in patients with systemic lupus erythematosus: is there a role for antiphospholipid antibodies? Ann Rheum Dis, 2000, 59(6): 462-467.
13.	Nagasawa K, Tada Y, Koarada S, et al. Very early development of steroid-associated osteonecrosis of femoral head in systemic lupus erythematosus: prospective study by MRI. Lupus, 2005, 14(5): 385-390.
14.	Gladman DD, Urowitz MB, Chaudhry-Ahluwalia V, et al. Predictive factors for symptomatic osteonecrosis in patients with systemic lupus erythematosus. J Rheumatol, 2001, 28(4): 761-765.
15.	Prupas HM, Patzakis M, Quismorio FP Jr. Total hip arthroplasty for avascular necrosis of the femur in systemic lupus erythematosus. Clin Orthop Relat Res 1981, (161): 186-190.
16.	Hanssen AD, Cabanela ME, Michet CJ Jr. Hip arthroplasty in patients with systemic lupus erythematosus. J Bone Joint Surg (Am), 1987, 69(6): 807-814.
17.	Ito H, Matsuno T, Hirayama T, et al. Health-related quality of life in patients with systemic lupus erythematosus after medium to long-term follow-up of hip arthroplasty. Lupus, 2007, 16(5): 318-323.
18.	Takahashi R, Tsutsumi A, Ohtani K, et al. Anti-mannose binding lectin antibodies in sera of Japanese patients with systemic lupus erythematosus. Clin Exp Immunol, 2004, 136(3): 585-590.
19.	Doria A, Iaccarino L, Ghirardello A, et al. Long-term prognosis and causes of death in systemic lupus erythematosus. Am J Med, 2006, 119(8): 700-706.
20.	Orban H, Cîrstoiu C, Adam R. Total hip arthroplasty in secondary systemic lupus erythematosus femoral head avascular necrosis. Rom J Intern Med, 2007, 45(1): 123-129.
21.	Bhan S, Eachempati KK, Malhotra R. Primary cementless total hip arthroplasty for bony ankylosis in patients with ankylosing spondylitis. J Arthroplasty, 2008, 23(6): 859-866.
22.	Smilowicz M, Kowalczewski JB. Long term results after total hip replacement—cemented and cementless in young rheumatic patients. Chir Narzadow Ruchu Ortop Pol, 2005, 70(5): 319-323.
23.	Joshi AB, Markovic L, Hardinge K, et al. Total hip arthroplasty in ankylosing spondylitis: an analysis of 181 hips. J Arthroplasty, 2002, 17(4): 427-433.
24.	Brinker MR, Rosenberg AG, Kull L, et al. Primary noncemented total hip arthroplasty in patients with ankylosing spondylitis. Clinical and radiographic results at an average follow-up period of 6 years. J Arthroplasty, 1996, 11(7): 802-812.

1. Zangger P, Gladman DD, Urowitz MB, et al. Outcome of total hip replacement for avascular necrosis in systemic lupus erythematosus. J Rheumatol, 2000, 27(4): 919-923.
2. Chong RW, Chong CS, Lai CH. Total hip arthroplasty in patients with chronic autoimmune inflammatory arthroplasties. Int J Rheum Dis, 2010, 13(3): 235-239.
3. Pietrzak K, Strzyzewski W, Kaczmarek W, et al. Total hip replacement in treatment of patients with deformity of the hip caused by ankylosing spondylitis. Chir Narzadow Ruchu Ortop Pol, 2010, 75(5): 282-286.
4. Keats AS. The ASA classification of physical status—a recapitulation. Anesthesiology, 1978, 49(4): 233-236.
5. Harris WH, McCarthy JC Jr, O’ Neill DA. Femoral component loosening using contemporary techniques of femoral cement fixation. J Bone Joint Surg (Am), 1982, 64(7): 1063-1067.
6. Engh CA, Bobyn JD, Glassman AH. Porous-coated hip replacement. The factors governing bone ingrowth, stress shielding, and clinical results. J Bone Joint Surg (Br), 1987, 69(1): 45-55.
7. Kawamura H, Dunbar MJ, Murray P, et al. The porous coated anatomic total hip replacement. A ten to fourteen-year follow-up study of a cementless total hip arthroplasty. J Bone Joint Surg (Am), 2001, 83-A (9): 1333-1338.
8. Engh CA, Massin P, Suthers KE. Roentgenographic assessment of the biologic fixation of porous-surfaced femoral components. Clin Orthop Relat Res, 1990, (257): 107-128.
9. Brooker AF, Bowerman JW, Robinson RA, et al. Ectopic ossification following total hip replacement. Incidence and a method of classification. J Bone Joint Surg (Am), 1973, 55(8): 1629-1632.
10. Zizic TM, Marcoux C, Hungerford DS, et al. Corticosteroid therapy associated with ischemic necrosis of bone in systemic lupus erythematosus. Am J Med, 1985, 79(5): 596-604.
11. Mont MA, Glueck CJ, Pacheco IH, et al. Risk factors for osteonecrosis in systemic lupus erythematosus. J Rheumatol, 1997, 24(4): 654-662.
12. Mok MY, Farewell VT, Isenberg DA. Risk factors for avascular necrosis of bone in patients with systemic lupus erythematosus: is there a role for antiphospholipid antibodies? Ann Rheum Dis, 2000, 59(6): 462-467.
13. Nagasawa K, Tada Y, Koarada S, et al. Very early development of steroid-associated osteonecrosis of femoral head in systemic lupus erythematosus: prospective study by MRI. Lupus, 2005, 14(5): 385-390.
14. Gladman DD, Urowitz MB, Chaudhry-Ahluwalia V, et al. Predictive factors for symptomatic osteonecrosis in patients with systemic lupus erythematosus. J Rheumatol, 2001, 28(4): 761-765.
15. Prupas HM, Patzakis M, Quismorio FP Jr. Total hip arthroplasty for avascular necrosis of the femur in systemic lupus erythematosus. Clin Orthop Relat Res 1981, (161): 186-190.
16. Hanssen AD, Cabanela ME, Michet CJ Jr. Hip arthroplasty in patients with systemic lupus erythematosus. J Bone Joint Surg (Am), 1987, 69(6): 807-814.
17. Ito H, Matsuno T, Hirayama T, et al. Health-related quality of life in patients with systemic lupus erythematosus after medium to long-term follow-up of hip arthroplasty. Lupus, 2007, 16(5): 318-323.
18. Takahashi R, Tsutsumi A, Ohtani K, et al. Anti-mannose binding lectin antibodies in sera of Japanese patients with systemic lupus erythematosus. Clin Exp Immunol, 2004, 136(3): 585-590.
19. Doria A, Iaccarino L, Ghirardello A, et al. Long-term prognosis and causes of death in systemic lupus erythematosus. Am J Med, 2006, 119(8): 700-706.
20. Orban H, Cîrstoiu C, Adam R. Total hip arthroplasty in secondary systemic lupus erythematosus femoral head avascular necrosis. Rom J Intern Med, 2007, 45(1): 123-129.
21. Bhan S, Eachempati KK, Malhotra R. Primary cementless total hip arthroplasty for bony ankylosis in patients with ankylosing spondylitis. J Arthroplasty, 2008, 23(6): 859-866.
22. Smilowicz M, Kowalczewski JB. Long term results after total hip replacement—cemented and cementless in young rheumatic patients. Chir Narzadow Ruchu Ortop Pol, 2005, 70(5): 319-323.
23. Joshi AB, Markovic L, Hardinge K, et al. Total hip arthroplasty in ankylosing spondylitis: an analysis of 181 hips. J Arthroplasty, 2002, 17(4): 427-433.
24. Brinker MR, Rosenberg AG, Kull L, et al. Primary noncemented total hip arthroplasty in patients with ankylosing spondylitis. Clinical and radiographic results at an average follow-up period of 6 years. J Arthroplasty, 1996, 11(7): 802-812.

Chinese Journal of Reparative and Reconstructive Surgery

MIDDLE- AND LONG-TERM EFFECTIVENESS OF PRIMARY TOTAL HIP ARTHROPLASTY FOR PATIENTS WITH CHRONIC AUTOIMMUNE INFLAMMATORY DISEASE

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