Minimum 10-year results of cementless total hip arthroplasty in patients with rheumatoid arthritis. Issue 4 (4th July 2017)

• Record Type: Journal Article
• Authors: Haraguchi, Akihisa; Nakashima, Yasuharu; Miyahara, Hisaaki; Esaki, Yukio; Okazaki, Ken; Fukushi, Jun-ichi; Hirata, Go; Ikemura, Satoshi; Kamura, Satoshi; Sakuraba, Koji; Fujimura, Kenjiro; Akasaki, Yukio; Yamada, Hisakata
• Is Part Of: Modern rheumatology. Volume 27:Issue 4(2017)
• Page Start: 598
• Page End: 604
• Publication Date: 2017-07-04
• Subjects: Cementless total hip arthroplasty -- Long-term results -- Mortality -- Rheumatoid arthritis; Rheumatology -- Periodicals; 616.723005
• DOI: 10.1080/14397595.2016.1256024
• Languages: English
• ISSNs: 1439-7595

Abstract

Abstract: Objectives: To retrospectively evaluate the long-term results of cementless total hip arthroplasty (THA) in patients with rheumatoid arthritis (RA) and postoperative patient mortality after THA. Methods: This study included 191 hips in 149 RA patients who underwent cementless THA between 1998 and 2005. Mean age at surgery was 54.2 years, and mean follow-up was 12.6 years. Implant and patient survivorships were determined using the Kaplan–Meier method, and the associated influencing factors were determined. Results: Implant survivals at 17 years were 99.5% for stems, 93.9% for cups, and 90.8% for liners. Among the liners used, THAs with highly cross-linked polyethylene showed better survivals compared with those with conventional polyethylene and alumina-bearing surface (93.4%, 90.9%, and 52.2%, respectively). A total of 64 deaths occurred; 45 patients died within 10 years and 19 patients died between 10 and 17 years. Malignancy (25.0%) was the leading cause of death, followed by pneumonia (20.8%) and sepsis (20.8%). The patient survival rate was 36.9% at 17 years after THA. Multivariate analysis exhibited that older age at operation and greater dose of concomitant corticosteroid resulted in shorter patient survivals. Conclusions: Cementless THA worked well in patients with RA. Mortality remained high among RA patients who needed THA.