title: Acetabular revision with impacted morselized cancellous bone graft and a cemented cup in patients with rheumatoid arthritis. A concise follow-up, at eight to nineteen years, of a previous report.
abstract: We previously reported our results at a minimum of three years after thirty-five revisions of total hip arthroplasty acetabular components in twenty-eight patients with rheumatoid arthritis. The revisions were performed with use of impacted morselized bone graft and a cemented cup. This update report presents the results at eight to nineteen years after the surgery, which, to our knowledge, is the longest follow-up available in the literature. No patient was lost to follow-up. Since our previous report, there were two additional cup failures due to aseptic loosening, at ten and sixteen years postoperatively. Kaplan-Meier analysis showed the probability of survival of the acetabular component at twelve years to be 80% (95% confidence interval, 65% to 95%) with removal of the cup for any reason as the end point and 85% (95% confidence interval, 71% to 99%) with aseptic loosening as the end point. Cup revisions performed with cement and use of impaction bone-grafting in patients with rheumatoid arthritis led to acceptable long-term prosthetic survival rates. This technique is attractive from a biological standpoint because of the possibility of maintaining acetabular bone stock.
authors.affiliation: Department of Orthopaedics, Radboud University Nijmegen Medical Centre, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands. B.Schreurs@orthop.umcn.nl
authors.forename: B Willem
authors.initials: BW
authors.lastname: Schreurs
authors.forename: Jaap
authors.initials: J
authors.lastname: Luttjeboer
authors.forename: Truike M
authors.initials: TM
authors.lastname: Thien
authors.forename: Maarten C
authors.initials: MC
authors.lastname: de Waal Malefijt
authors.forename: Pieter
authors.initials: P
authors.lastname: Buma
authors.forename: René P H
authors.initials: RP
authors.lastname: Veth
authors.forename: Tom J J H
authors.initials: TJ
authors.lastname: Slooff
mesh_terms: D000077:Acetabulum / Q000601:surgery*; D000328:Adult; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000601:surgery*; D019644:Arthroplasty, Replacement, Hip / Q000379:methods*; D016025:Bone Transplantation; D002484:Cementation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D011475:Prosthesis Failure; D012086:Reoperation / Q000706:statistics & numerical data; D016896:Treatment Outcome