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[Middle- and long-term effectiveness of primary total hip arthroplasty for patients with chronic autoimmune
Yan Kang1, Ziji Zhang, Zhiqi Zhang
1Department of Joint Surgery, First Affiliated Hospital of Sun Yat-sen University, Guangzhou Guangdong 510080, PR China.
Insights
Total hip arthroplasty (THA) offers significant long-term benefits for patients with chronic autoimmune inflammatory diseases, improving hip function and quality of life. This study confirms THA as an effective treatment option for these challenging conditions.
Area of Science:
- Orthopedic Surgery
- Rheumatology
- Immunology
Background:
- Chronic autoimmune inflammatory diseases often lead to severe hip joint damage.
- Total hip arthroplasty (THA) is a surgical option for end-stage hip disease.
- Effectiveness of THA in this specific patient population requires long-term evaluation.
Purpose of the Study:
- To assess the middle- and long-term outcomes of primary total hip arthroplasty (THA).
- To evaluate THA effectiveness in patients suffering from chronic autoimmune inflammatory diseases.
- To analyze functional improvements and complication rates following THA in this cohort.
Main Methods:
- A cohort of 42 patients (51 hips) with autoimmune inflammatory diseases underwent THA between 1990 and 2006.
- Patients included those with rheumatoid arthritis, systemic lupus erythematosus, and ankylosing spondylitis.
- Pre- and post-operative Harris scores and SF-36 health survey scores (PCS and MCS) were analyzed.
Main Results:
- Significant improvements in Harris scores (32.49 to 89.25) and SF-36 scores (PCS: 25.53 to 51.35, MCS: 42.28 to 55.29) were observed.
- Follow-up ranged from 5 to 21 years (mean 9.1 years), demonstrating sustained benefits.
- Complications included limp, dislocation, fracture, aseptic loosening, and ectopic ossification, with varying frequencies.
Conclusions:
- Total hip arthroplasty (THA) demonstrates favorable middle- and long-term effectiveness for patients with chronic autoimmune inflammatory diseases.
- THA significantly improves hip function and health-related quality of life in this patient group.
- While complications can occur, THA is a viable and beneficial treatment option for severe hip involvement due to autoimmune conditions.
Objective:
To evaluate the middle- and long-term effectiveness of primary total hip arthroplasty (THA) in patients with chronic autoimmune inflammatory diseases.
Methods:
Between 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.
Results:
All 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 < 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).
Conclusion:
THA seems to be a good choice for patients with chronic autoimmune inflammatory diseases.