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Radiological loosening after cemented hip replacement for juvenile chronic arthritis
I D Learmonth1, A W Heywood, J Kaye
1Department of Orthopaedic Surgery, Princess Alice Orthopaedic Hospital, University of Cape Town, Republic of South Africa.
The Journal of Bone and Joint Surgery. British Volume
|March 1, 1989
Summary
Total hip replacement in juvenile chronic arthritis offers sustained pain relief but limited movement. While no revisions were needed, many hips show signs of future failure, highlighting long-term challenges.
Area of Science:
- Orthopedic Surgery
- Rheumatology
- Pediatric Orthopedics
Background:
- Juvenile chronic arthritis (JCA) frequently affects multiple joints, leading to significant disability.
- Total hip replacement (THR) is a surgical option for severe hip involvement in JCA.
- Long-term outcomes and failure predictors for THR in JCA patients are not fully understood.
Purpose of the Study:
- To evaluate the long-term outcomes of total hip replacement in patients with juvenile chronic arthritis.
- To identify potential risk factors for implant failure in this patient population.
Main Methods:
- Retrospective review of 14 total hip replacements in 14 patients with JCA.
- Mean patient age at operation was 16 years (range 12-22 years).
- Mean follow-up duration was 8.5 years (range 4-11 years).
Main Results:
- Sustained postoperative pain relief in 13 out of 14 hips.
- Significant restriction in joint movement persisted postoperatively.
- No hip required revision surgery during the follow-up period.
- Radiological signs suggestive of impending failure were observed in 8 hips (57%).
Conclusions:
- Total hip replacement provides significant pain relief for JCA patients but does not fully restore joint function.
- Radiological evidence of impending failure is common, suggesting potential long-term complications.
- Factors such as ongoing bone growth and adolescent immune changes may contribute to implant loosening in JCA patients.