title: Total hip arthroplasty with bone graft for acetabular protrusion in rheumatoid arthritis.
abstract: Abstract Twenty-five hips in 19 rheumatoid arthritis (RA) patients with protrusio acetabuli were followed up, both clinically and radiographically, for more than 9 years after total hip arthroplasty (THA), that was performed with a bone graft to reinforce the medial acetabular wall. Radiographs were taken preoperatively and every 6 months postoperatively. Clinical assessments of pain, gait, and range of motion of the hips were obtained preoperatively and every year postoperatively using the Japanese Orthopaedic Association hip-scoring system. Radiographs showed that bony union had occurred in all cases. Six acetabular components were loose, but no femoral components became loose during the 9-year period. The clinical evaluation showed that relief of pain was very significant. The range of motion of the hip joints also improved from 12 points to 16.6 points after 9 years. Walking ability improved, but is becoming worse as time goes by. The radiographic results were compared with the results of a THA group with RA that had not had a bone graft. The rate of loosening of the THA without a bone graft was significantly higher than that of THA with a bone graft. We concluded that bone grafting for protrusio acetabuli was a very useful procedure.
authors.affiliation: Department of Orthopedic Surgery and Rheumatology, Nagoya National Hospital , 4-1-1 San-nomaru, Naka-ku, Nagoya 460-0001 , Japan.
authors.forename: K
authors.initials: K
authors.lastname: Kondo
authors.forename: T
authors.initials: T
authors.lastname: Asai
authors.forename: M
authors.initials: M
authors.lastname: Tsukamoto