Bipolar hemiarthroplasty in juvenile rheumatoid arthritis: long-term survivorship and outcomes.
Because controversy surrounds the management of end-stage hip disease in juvenile rheumatoid arthritis (JRA), this study evaluated the long-term outcome of bipolar hemiarthroplasty as an alternative to conventional joint arthroplasty. A total of 24 JRA patients underwent 39 hemiarthroplasties; follow-up averaged 12 years (range, 3 to 15 years). There were 14 hips (36%) revised, and 25 hips (64%) maintained the original components. Mean Harris hip scores in surviving hips improved from 29 to 69 points (P<.001). Radiographs showed progressive bipolar superomedial migration (P<.01) despite attempted augmentation. Failure defined as revision to total hip arthroplasty or definite radiographic loosening occurred in 15 hips (38%). Ten-year Kaplan-Meier survivorship for all prostheses was 78%. Independent multivariate risk factors for failure included acetabular grafting (P =.006), prosthesis type (P<.001), and unilateral replacement (P<.001).
Yun
Andrew G
AG
Arthritis Institute, Inglewood, California, USA. yuna@hss.edu
Martin
Scott
S
Zurakowski
David
D
Scott
Richard
R
D000293:Adolescent; D000328:Adult; D001171:Arthritis, Juvenile / Q000601:surgery*; D019644:Arthroplasty, Replacement, Hip / Q000379:methods*; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011475:Prosthesis Failure; D016896:Treatment Outcome