title: Total hip replacement in adult patients with severe Kashin-Beck disease of the hip.
abstract: The treatment of elderly patients with Kashin-Beck disease (KBD) remains clinically challenging, and clinical data are very lacking. The aim of this study was to retrospectively evaluate pain and functional outcomes following total hip replacement in adult patients with severe KBD of the hip.
  
  
  
  Twenty-two patients (32 hips) with KBD underwent primary hip replacement and were followed for at least 2 years. Radiographic and Clinical assessments were evaluated for each patient at 2 and 4 weeks and at 3, 6 and 12 months after the operation and annually thereafter. The efficacy index included the visual analogue scale (VAS) score, Harris hip score, functional score for adult Tibetans with Kashin-Beck Disease (FSAT-KBD) and radiographic outcomes.
  
  
  
  The patients underwent a follow-up, and the mean follow-up time was 3.8 years. VAS scores significantly decreased within the first 6 months postoperatively. This decrease continued until the final follow-up (p < 0.01). This result was supported by a significant increase in the Harris and FSAT-KBD scores after the surgery (p < 0.01). At the final follow-up, there was no change in prosthesis positioning or radiographic evidence of prosthesis loosening. One case received impacted allograft bone croutons and had worn polyethylene components replaced after 6 years because the patient suffered severe pelvic and femoral osteolytic lesions postoperatively.
  
  
  
  Hip replacement can relieve pain and improve joint function in treating severe KBD hip. Additional studies that are more extensive are needed to confirm the findings of our study.
authors.affiliation: Department of Orthopedic Surgery, West China Hospital of Sichuan University, No.37, Guoxue Alley, Chengdu, 610041, China.
authors.forename: Xin
authors.initials: X
authors.lastname: Tang
authors.affiliation: Respiratory and Thoracic Surgery Ward, West China Hospital of Sichuan University, No.37, Guoxue Alley, Chengdu, 610041, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Zhu
authors.affiliation: Department of Orthopedic Surgery, West China Hospital of Sichuan University, No.37, Guoxue Alley, Chengdu, 610041, China. zongke@126.com.
authors.forename: Zongke
authors.initials: Z
authors.lastname: Zhou
authors.affiliation: Department of Orthopedic Surgery, West China Hospital of Sichuan University, No.37, Guoxue Alley, Chengdu, 610041, China.
authors.forename: Bin
authors.initials: B
authors.lastname: Shen
authors.affiliation: Department of Orthopedic Surgery, West China Hospital of Sichuan University, No.37, Guoxue Alley, Chengdu, 610041, China.
authors.forename: Pengde
authors.initials: P
authors.lastname: Kang
authors.affiliation: Department of Orthopedic Surgery, West China Hospital of Sichuan University, No.37, Guoxue Alley, Chengdu, 610041, China. peifuxing@vip.163.com.
authors.forename: Fuxing
authors.initials: F
authors.lastname: Pei
authors.affiliation: Department of Orthopedic Surgery, West China Hospital of Sichuan University, No.37, Guoxue Alley, Chengdu, 610041, China.
authors.forename: Jian
authors.initials: J
authors.lastname: Li
mesh_terms: D000368:Aged; D064591:Allografts / Q000000981:diagnostic imaging / Q000637:transplantation; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects* / Q000295:instrumentation; D016025:Bone Transplantation / Q000009:adverse effects; D002358:Cartilage, Articular / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006621:Hip Joint / Q000000981:diagnostic imaging / Q000601:surgery; D006622:Hip Prosthesis / Q000009:adverse effects; D006801:Humans; D057767:Kashin-Beck Disease / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D059408:Pain Management / Q000379:methods*; D010147:Pain Measurement; D011183:Postoperative Complications / Q000453:epidemiology*; D011184:Postoperative Period; D011475:Prosthesis Failure; D011859:Radiography; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: Hip; Kashin-Beck disease; Replacement