| Abstract | INTRODUCTION: We evaluated the long-term outcomes for combined, bilateral total knee and hip arthroplasty performed on a group of very young patients with juvenile rheumatoid arthritis. MATERIALS AND METHODS: Six consecutive patients with a mean age of 14 years at the time of hip replacement and 16 years at knee replacement were analyzed. Five of the six patients were wheelchair dependent pre-operatively. All knee components had uncemented fixation, while the hip replacements were a mixed group of cemented and uncemented prostheses. RESULTS: Clinical and radiographic follow-up at a mean duration of 13.8 years for the hips and 17.3 years for the knees demonstrated four of the six patients were unlimited community ambulators, one a limited community ambulator and the remaining patient a household ambulator. Failure, defined as revision of any of the components or definite radiographic loosening, occurred in three knees (two patients) and five hips (three patients). CONCLUSIONS: These good long-term functional results in a relatively very young population indicate that an early and aggressive approach to multiple joint disease is an appropriate option at a young age for patients with juvenile rheumatoid arthritis with severe disability and pain refractory to conservative management. |
| Authors | Kevin J Mulhall, Khaled J Saleh, Corey A Thompson, Erik P Severson, David H Palmer
(Affiliation: Department of Orthopaedic Surgery, Mater Misericordiae University Hospital, Eccles Street, Dublin 7, Ireland. kjm at indigo.ie)
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| Journal | Archives of orthopaedic and trauma surgery
(Arch Orthop Trauma Surg)
Vol. 128
Issue 3
Pg. 249-54
(Mar 2008)
ISSN: 0936-8051 Germany |
| PMID | 17874245
(Publication Type: Journal Article)
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| Topics |
- Adolescent
- Arthritis, Juvenile Rheumatoid
(physiopathology, surgery)
- Arthroplasty, Replacement, Hip
- Arthroplasty, Replacement, Knee
- Female
- Hip Prosthesis
- Humans
- Knee Prosthesis
- Prosthesis Failure
- Range of Motion, Articular
- Recovery of Function
- Retrospective Studies
- Treatment Outcome
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