title: Minimum 10-year results of cementless total hip arthroplasty in patients with rheumatoid arthritis.
abstract: OBJECTIVE
  To retrospectively evaluate the long-term results of cementless total hip arthroplasty (THA) in patients with rheumatoid arthritis (RA) and postoperative patient mortality after THA.
  
  
  METHODS
  This study included 191 hips in 149 RA patients who underwent cementless THA between 1998 and 2005. Mean age at surgery was 54.2 years, and mean follow-up was 12.6 years. Implant and patient survivorships were determined using the Kaplan-Meier method, and the associated influencing factors were determined.
  
  
  RESULTS
  Implant survivals at 17 years were 99.5% for stems, 93.9% for cups, and 90.8% for liners. Among the liners used, THAs with highly cross-linked polyethylene showed better survivals compared with those with conventional polyethylene and alumina-bearing surface (93.4%, 90.9%, and 52.2%, respectively). A total of 64 deaths occurred; 45 patients died within 10 years and 19 patients died between 10 and 17 years. Malignancy (25.0%) was the leading cause of death, followed by pneumonia (20.8%) and sepsis (20.8%). The patient survival rate was 36.9% at 17 years after THA. Multivariate analysis exhibited that older age at operation and greater dose of concomitant corticosteroid resulted in shorter patient survivals.
  
  
  CONCLUSIONS
  Cementless THA worked well in patients with RA. Mortality remained high among RA patients who needed THA.
authors.affiliation: a Department of Orthopaedic Surgery , Kyushu University , Fukuoka , Japan.
authors.forename: Akihisa
authors.initials: A
authors.lastname: Haraguchi
authors.affiliation: a Department of Orthopaedic Surgery , Kyushu University , Fukuoka , Japan.
authors.forename: Yasuharu
authors.initials: Y
authors.lastname: Nakashima
authors.affiliation: b Department of Orthopedics , National Hospital Organization Kyushu Medical Center , Fukuoka , Japan.
authors.forename: Hisaaki
authors.initials: H
authors.lastname: Miyahara
authors.affiliation: b Department of Orthopedics , National Hospital Organization Kyushu Medical Center , Fukuoka , Japan.
authors.forename: Yukio
authors.initials: Y
authors.lastname: Esaki
authors.affiliation: a Department of Orthopaedic Surgery , Kyushu University , Fukuoka , Japan.
authors.forename: Ken
authors.initials: K
authors.lastname: Okazaki
authors.affiliation: a Department of Orthopaedic Surgery , Kyushu University , Fukuoka , Japan.
authors.forename: Jun-Ichi
authors.initials: JI
authors.lastname: Fukushi
authors.affiliation: b Department of Orthopedics , National Hospital Organization Kyushu Medical Center , Fukuoka , Japan.
authors.forename: Go
authors.initials: G
authors.lastname: Hirata
authors.affiliation: a Department of Orthopaedic Surgery , Kyushu University , Fukuoka , Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Ikemura
authors.affiliation: b Department of Orthopedics , National Hospital Organization Kyushu Medical Center , Fukuoka , Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Kamura
authors.affiliation: b Department of Orthopedics , National Hospital Organization Kyushu Medical Center , Fukuoka , Japan.
authors.forename: Koji
authors.initials: K
authors.lastname: Sakuraba
authors.affiliation: b Department of Orthopedics , National Hospital Organization Kyushu Medical Center , Fukuoka , Japan.
authors.forename: Kenjiro
authors.initials: K
authors.lastname: Fujimura
authors.affiliation: a Department of Orthopaedic Surgery , Kyushu University , Fukuoka , Japan.
authors.forename: Yukio
authors.initials: Y
authors.lastname: Akasaki
authors.affiliation: c Kondo Clinic of Rheumatology and Orthopaedic Surgery , Fukuoka , Japan.
authors.forename: Hisakata
authors.initials: H
authors.lastname: Yamada
mesh_terms: D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011475:Prosthesis Failure / Q000209:etiology*
keywords: Cementless total hip arthroplasty; Long-term results; Mortality; Rheumatoid arthritis