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Protrusio acetabuli in rheumatoid arthritis
Clinical Orthopaedics and Related Research
|May 1, 1975
Summary
Protrusio acetabuli, a common rheumatoid arthritis complication, involves inward femoral head migration. This progression, influenced by adrenal cortical steroids, can be managed with early surgical intervention to prevent further issues.
Area of Science:
- Orthopedics
- Rheumatology
- Radiology
Background:
- Protrusio acetabuli is a frequent complication in rheumatoid arthritis patients.
- The deformity involves the inward migration of the femoral head into the pelvis.
- Serial roentgenograms are used to monitor the progression of this condition.
Purpose of the Study:
- To analyze the progression of protrusio acetabuli in rheumatoid arthritis.
- To investigate the potential role of adrenal cortical steroids in its etiology.
- To discuss management strategies for intrapelvic protrusion after total hip replacement.
Main Methods:
- Measurement of femoral head and acetabular roof migration using serial roentgenograms.
- Correlation of radiographic findings with clinical presentation in rheumatoid arthritis.
- Review of cases involving intrapelvic protrusion of prosthetic acetabulum post-total hip replacement.
Main Results:
- Femoral head inward progression occurs due to acetabular roof upward migration and femoral head collapse in a roughly 2:1 ratio.
- Adrenal cortical steroids are implicated as a potential contributing factor to the etiology.
- Intrapelvic protrusion of prosthetic acetabulum is a recognized complication following total hip arthroplasty.
Conclusions:
- Early surgical intervention for rapidly progressing protrusio acetabuli may prevent complications.
- Understanding the biomechanics and etiological factors is crucial for managing this condition.
- Management strategies should address both native and post-prosthetic protrusio acetabuli.