Cementless femoral fixation in the rheumatoid patient undergoing total hiparthroplasty - Minimum 5-year results

Sixty-two total hip arthroplasties in 49 patients with a diagnosis of rheum atoid arthritis were performed between November 1986 and December 1992. All components were titanium alloy with a circumferential plasma-spray porous coating. Four patients (4 hips) died before 5-year follow-up, and 6 patient s (8 hips) were lust to follow-up, leaving 39 patients (50 hips) for review at a minimum 5-year follow-up after surgery (mean, 8 years; range, 5-12 ye ars). There were 12 men and 27 women, with a mean age at time of surgery of 55 years (range, 25-77 years) and a mean weight of 69 kg (range. 42-109 kg ). Compared with the preoperative Charnley scores, there was significant im provement in the postoperative scores: pain, from 2.7 to 5.7, and function, from 3.2 to 5.3. Thigh pain was present in 1 patient (1 hip) (2.0%). No fe moral fractures occurred intraoperatively with the insertion of the prosthe sis, Spot welds consistent with bone ingrowth were identified in all of the femoral components. No femoral components showed evidence of radiographic loosening or required revision for aseptic loosening or incapacitating thig h pain, but 7 acetabular revisions were performed. Uncemented femoral fixat ion with this component design in rheumatoid patients appears to be a promi sing treatment.