Hip arthroplasty in patients with tabetic charcot joints

The results of 10 hip procedures in seven patients with Charcot arthropathy secondary to tabes dorsalis were reviewed clinically and radiographically. Three total hip replacements, three cemented Moore prostheses, two cup arthroplasties, one girdlestone, and one fusion were performed. All patients except one had significant pain as a predominant preoperative symptom. Followup ranged from three to 10 years (average 5.3 years). All three total hip replacements remained dislocated after repeated closed reduction. One Moore prosthesis was chronically dislocated, one subluxed, and one loosened. Both cup arthroplasties dislocated, but one remained reduced after closed reduction. There was long term improvement in all hips only in the pain category. Function, walking, and motion were not improved. Despite overall hip ratings of poor or failure in nine of 10 hips, patients were satisfied in seven of 10 hips. Key words: hip arthroplasty, Charcot arthropathy, tabes dorsalis.