Midterm results of cementless total hip replacement in rapidly destructive arthropathy and a review of the literature.
OBJECTIVE
Rapidly destructive arthropathy (RDA) of the hip is a disease of unknown etiology characterized by a rapid destruction of the acetabular and femoral aspects of the hip joint. The purpose of this study was to assess the outcome of cementless total hip replacement in this category of patients.


METHODS
A prospective study was performed of all cases of rapidly destructive arthropathy treated by cementless total hip replacement between 1998 and 2005. There were 6 female patients (8 hips) meeting the criteria of RDA. Median age at surgery was 74 years (range 64-83). Using the Paprosky classification of acetabular defects, five hips had a type 2B acetabular defect and three a type 3A acetabular defect. In all cases a cementless prosthesis was used. In two cases a shelf plasty of the acetabulum was added. Radiographic and clinical follow-up was performed up to 9 years postoperatively (mean follow-up 69 months, range 24-104 months).


RESULTS
At radiographic follow-up, no signs of prosthetic loosening or migration were seen. Harris Hip Score improved from 25.8 (SD 7.3, range 11-34) preoperatively to 88.3 (SD 9.7, range 71-98) at latest follow-up.


CONCLUSIONS
Cementless total hip replacement in patients with rapidly destructive arthropathy led to a good result in a series of eight cases at midterm follow-up.
Peters
Karin S
KS
Department of Orthopaedic Surgery, Orthopaedic Research Institute, St George Hospital Campus, Sydney, Australia. petersks@hotmail.com
Doets
H Cornelis
HC
D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000295:instrumentation* / Q000379:methods / Q000534:rehabilitation; D005260:Female; D006622:Hip Prosthesis; D006801:Humans; D008875:Middle Aged; D015207:Osteoarthritis, Hip / Q000000981:diagnostic imaging / Q000601:surgery*; D011446:Prospective Studies; D011474:Prosthesis Design; D011859:Radiography; D020127:Recovery of Function; D012720:Severity of Illness Index