Bipolar hemiarthroplasty in juvenile rheumatoid arthritis: long-term survivorship and outcomes.

Abstract

Because controversy surrounds the management of end-stage hip disease in juvenile rheumatoid arthritis (JRA), this study evaluated the long-term outcome of bipolar hemiarthroplasty as an alternative to conventional joint arthroplasty. A total of 24 JRA patients underwent 39 hemiarthroplasties; follow-up averaged 12 years (range, 3 to 15 years). There were 14 hips (36%) revised, and 25 hips (64%) maintained the original components. Mean Harris hip scores in surviving hips improved from 29 to 69 points (P<.001). Radiographs showed progressive bipolar superomedial migration (P<.01) despite attempted augmentation. Failure defined as revision to total hip arthroplasty or definite radiographic loosening occurred in 15 hips (38%). Ten-year Kaplan-Meier survivorship for all prostheses was 78%. Independent multivariate risk factors for failure included acetabular grafting (P =.006), prosthesis type (P<.001), and unilateral replacement (P<.001).

• Authors: Andrew G Yun, Scott Martin, David Zurakowski, Richard Scott
• Journal: The Journal of arthroplasty (J Arthroplasty) Vol. 17 Issue 8 Pg. 978-86 (Dec 2002) ISSN: 0883-5403 [Print] United States
• PMID: 12478506 (Publication Type: Journal Article)
• Copyright: Copyright 2002, Elsevier Science (USA). All rights reserved.

Topics

• Adolescent
• Adult
• Arthritis, Juvenile (surgery)
• Arthroplasty, Replacement, Hip (methods)
• Child
• Female
• Humans
• Male
• Middle Aged
• Prosthesis Failure
• Treatment Outcome