title: Long-term results of cementless primary total hip arthroplasty with a threaded cup and a tapered, rectangular titanium stem in rheumatoid arthritis and osteoarthritis.
abstract: The aim of this study was to assess the outcome of primary cementless total hip arthroplasty in rheumatoid arthritis patients and to compare the results with osteoarthritis patients. Sixty-four patients (77 hips) with rheumatoid arthritis and 120 patients (135 hips) with osteoarthritis had a conical-shaped Zweymueller threaded cup and a tapered, rectangular Zweymueller stem implanted and were assessed after an average of 12.5 years. The endpoints for survival analysis were failure of one or both components due to radiographic loosening or revision. Revision was defined as exchange of cup, stem or both. When the PE-insert or the ceramic ball head were exchanged leaving cup and stem in place, e.g. for PE-wear or dislocation, this was not considered a revision but a re-intervention. No differences were found in survival rates; however, in the rheumatoid arthritis group there was an increased rate of malposition of the cup, avulsions of the greater trochanter, and increased bone resorption in the trochanteric region. This study shows that despite altered biomechanical properties of rheumatoid bone, mechanical stability and osseous integration of cementless prosthesis are not compromised and, although a higher complication rate did occur, long-term survival is excellent.
authors.affiliation: Department of Orthopaedic Surgery, Slotervaartziekenhuis, Louwesweg 6, Amsterdam, The Netherlands. rzwartele@yahoo.com
authors.forename: Rob
authors.initials: R
authors.lastname: Zwartele
authors.forename: Anil
authors.initials: A
authors.lastname: Peters
authors.forename: Johannes
authors.initials: J
authors.lastname: Brouwers
authors.forename: Paul
authors.initials: P
authors.lastname: Olsthoorn
authors.forename: Ronald
authors.initials: R
authors.lastname: Brand
authors.forename: Cornelis
authors.initials: C
authors.lastname: Doets
mesh_terms: D000077:Acetabulum / Q000000981:diagnostic imaging; D000328:Adult; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000601:surgery*; D019644:Arthroplasty, Replacement, Hip / Q000379:methods; D005260:Female; D005269:Femur / Q000000981:diagnostic imaging; D006622:Hip Prosthesis; D006801:Humans; D007432:Intraoperative Period; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015207:Osteoarthritis, Hip / Q000601:surgery*; D011474:Prosthesis Design; D011859:Radiography; D012086:Reoperation; D014025:Titanium; D016896:Treatment Outcome
chemical_list: D014025:Titanium