[Rheumatoid hip joint and its orthopedic surgical treatment]

In the early stage of the disease, synovectomy of the hip seems to be a successful technique, but the timing of the operation is difficult because of interference with conservation treatment. Osteotomy in rheumatoid arthritis of the hip is not very successful; arthrodesis is not recommended. In the late stage of the disease the treatment of choice is joint replacement. Here osteoporosis and the protrusion of the acetabulum present more technical problems than in other hip diseases. Implants with various designs and various implantation techniques with or without bone cement are used. The use of bone grafts, especially for protrusion, represents real progress, and there is a trend toward using cementless implantation, especially for young patients. Failures are due to difficulties in morphology, but there are no more reoperations than in osteoarthritis, and mortality seems to be higher than in osteoarthritis.