Total hip arthroplasty has become a successful way of treating the painful
and destroyed hip joint in the patient with rheumatoid arthritis. Because o
f the underlying disease, it still is controversial whether the implants se
lected should be used with bone cement, or whether uncemented devices will
give equally good results in this population. Fifteen patients suffering fr
om rheumatoid arthritis underwent 21 hip arthroplasties, The followup perio
d averaged 3.3 years (range, 2.5-6.8 years). All but one patient were takin
g medication at the time of surgery for their underlying disease. Clinical
evaluation was based on a modified Harris hip score that showed significant
improvement in pain an function preoperatively compared with pain and func
tion at the most recent followup, Radiographic analysis revealed five cases
of minor migration of the acetabular components, and three cases of distal
migration of 2 mm or less in the femoral components. Complications consist
ed of heterotopic ossifications in one patient, and an intraoperative femor
al fracture in one patient. There were no infections, and there were no dee
p vein thromboses. The results in these patients suggest that cementless to
tal hip arthroplasty might become a successful way of treating the destroye
d hip joint in the patient,vith rheumatoid arthritis.