DOI: http://dx.doi.org/10.18203/issn.2455-4510.IntJResOrthop20201520

A prospective study on functional outcome of uncemented total hip arthroplasty in patients with inflammatory arthropathies

Girish Marappa, Vishwanath Muttagaduru Shivalingappa, Nuthan Jagadeesh, Arjun Mandri

Abstract


Background: Although medical management has improved the outcome and may have reduced the need for surgery, total hip arthroplasty (THA) is often required to manage pain and restore function and mobility. The successful functional outcome of THA in patients with inflammatory arthropathies is essential in understanding the need for THA, and its benefits in those undergoing it. Objective of the study is to evaluate the functional outcome of total hip arthroplasty in patients suffering from inflammatory arthritis using Harris hip score (HHS) and to assess the post operative complication in these patients.

Methods: In a prospective study conducted on patients with inflammatory arthritis treated with THA between a study period of January 2018 to January 2020. All the patients after assessing them clinically and radiologically were operated with uncemented THA through posterolateral approach. Functional outcomes of hip were evaluated using HHS at various intervals.

Results: In this study, patients were followed up to 24 months. About 46.7% of patients were diagnosed with rheumatoid arthritis, 33.3% of patients were diagnosed with ankylosing spondylitis, 20% of patients were diagnosed with sero negative arthritis. 90% of patients had no limb length discrepancy, no other post-operative complications were noted. The final functional outcome of hip according to HHS were 13.3% of excellent, 56.7% good results and 30% of fair results.

Conclusions: This study concludes that THA in patients with inflammatory arthritis with restricted activities of life had improved in short term follow up and ease of rehabilitation and return to function.


Keywords


Total hip arthroplasty, Harris hip score, Inflammatory arthritis, Rheumatiod arthritis, Ankylosing spondylitis

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References


Canale ST, Beaty JH, Campbell WC. Campbell's Operative Orthopaedics. Elsevier; 2012.

Jamsen E, Virta LJ, Hakala M, Kauppi MJ, Malmivaara A, Mu L. The Decline In Joint Replacement Surgery In Rheumatoid Arthritis Is Associated With A Concomitant Increase In The Intensity Of Anti-Rheumatic Therapy: A Nationwide Register-Based Study From 1995 Through 2010. Acta Orthop. 2013;84(4):331–7.

Hazes J, Luime J. The Epidemiology Of Early Inflammatory Arthritis. Nat Rev Rheumatol. 2011;7:381-90.

Sewerin P, Brinks R, Schneider M, Haase I, Vordenbäumen S. Prevalence and Incidence Of Psoriasis And Psoriatic Arthritis. Ann. Rheum. Dis. 2019;78(2):286-7.

Holroyd CR, Seth R, Bukhari M, Malaviya A, Holmes C, Curtis E, et al. The British Society For Rheumatology Biologic DMARD Safety Guidelines In Inflammatory Arthritis. Rheumatology (Oxford). 2019;58(2):220-6.

Zwartele RE, Witjes S, Doets HC, Stijnen T, Poll RG. Cementless Total Hip Arthroplasty In Rheumatoid Arthritis: A Systematic Review Of The Literature. Arch Orthop Trauma Surg. 2012;132:535-46.

Kim YH, Oh SH, Kim JS, Lee SH. Total Hip Arthroplasty For The Treatment Of Osseous Ankylosed Hips. Clin Orthop Relat Res. 2003;414:136-48.

Kuo AD, Zajac FE, A Biomechanical Analysis Of Muscle Strength As A Limiting Factor In Standing Posture. J Biomechanics. 1993;26:137-50.

Wang T, Sun J-Y, Zhao X-J, Liu Y, Yin H. Ceramic-On-Ceramic Bearings Total Hip Arthroplasty In Young Patients. Arthroplasty Today. 2016;2(4):205-9.

Greenky MR, Wang W, Ponzio DY, Courtney PM. Total Hip Arthroplasty and the Medicare Inpatient-Only List: An Analysis of Complications in Medicare-Aged Patients Undergoing Outpatient Surgery. J Arthroplasty. 2019;34(6):1250-4.

Mclaughlin JR, Lee KR. Total Hip Arthroplasty With An Uncemented Tapered Femoral Component In Patients Younger Than 50 Years. J Arthroplast. 2011;26:9-15.

Prakash S, Mehra NK, Bhargava SK. Ankylosing spondylitis in North India: A clinical and immunogenetic study. Annals Rheumatic Dis. 1984;43(3):381-5.

Biant LC, Clemen ND, Breusch SJ. Lower limb joint replacement in rheumatoid arthritis. J Orthop Surg Res. 2012;7(1):27.

Erik A, Schnaser MD, James A, Browne MD. Perioperative Complications in Patients With Inflammatory Arthropathy Undergoing Total Hip Arthroplasty. J Arthroplasty. 2016;31(10):2286-90.