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Total hip replacement in familial Mediterranean fever
M Salai1, P Langevitz, A Blankstein
1Department of Orthopaedic Surgery, Chaim Sheba Medical Center, Tel-Hashomer Hospital, Tel Aviv, Israel.
Bulletin (Hospital for Joint Diseases (New York, N.Y.))
|January 1, 1993
Summary
Familial Mediterranean fever (FMF) can severely damage hip joints, often requiring total hip replacement. Cementless prostheses after synovectomy are recommended for better outcomes in FMF patients.
Area of Science:
- Rheumatology
- Orthopedic Surgery
- Genetics
Background:
- Familial Mediterranean fever (FMF) is an inherited autoinflammatory disorder.
- FMF commonly affects individuals of Mediterranean descent, presenting with recurrent inflammatory attacks.
- Protracted FMF attacks can lead to severe hip joint damage, including cartilage destruction and avascular necrosis.
Observation:
- Eighteen FMF patients (19-52 years) underwent 22 total hip replacements between 1971 and 1985.
- A significant complication rate of aseptic loosening (6 of 18 initial prostheses) was observed.
- The hip joint is particularly vulnerable to damage from protracted FMF attacks.
Findings:
- Cementless hip prostheses following meticulous synovectomy are proposed as the preferred surgical approach.
- This strategy aims to improve the longevity and success rate of hip replacements in FMF patients.
- The study highlights the unique challenges and outcomes of total hip arthroplasty in the context of FMF.
Implications:
- This research suggests a refined surgical protocol for managing hip destruction in FMF.
- Improved surgical techniques may reduce revision rates and enhance patient quality of life.
- Further investigation into the long-term efficacy of cementless hip arthroplasty in FMF is warranted.