Rapidly progressive osteoarthrosis of the hip

A retrospective review of 991 primary total hip arthroplasties was performed to determine the incidence of rapidly progressive osteoarthrosis of the hip joint. Thirty-four patients (35 hips) were identified (3.5%). Females were predominantly affected (85%). A history of hypertension and regular non-steroidal anti-inflammatory drug use was significantly more common in those with rapid progression as compared to the normally progressive group. Transfusion requirements were also significantly greater for the rapidly progressive group. Patient age and operating time were both greater in those with rapid progression, but neither proved statistically significant. No significant difference was noted when comparing the affected side, body mass index or the pre-operative range of hip movements, ESR or Oxford Hip Score. From the radiographs, twenty cases were classified as type I (rapid), 11 type II (moderate) and 3 type III (delayed). Wear distribution was predominantly superolateral (85%) and anterosuperior (97%). All patients were treated by total hip arthroplasty. At latest follow-up (average, 18 months; range, 13-36 months) there was no significant difference in the Oxford Hip Score between the normally progressive and rapidly progressive groups. All radiographs were satisfactory. Total hip arthroplasty in these cases is technically challenging. When identified, such individuals should be given priority treatment due to the potentially rapid and extensive loss of bone stock that can occur. (Hip International 2004; 14: 217-22).