Uncemented total hip arthroplasty in patients with rheumatoid arthritis

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.