Long-term Results of Charnley Low-friction Arthroplasty in Rheumatoid Arthritis-A Comparison of Results between Rheumatoid Arthritis and Osteoarthritis.:-A Comparison of Results between Rheumatoid Arthritis and Osteoarthritis-

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A long-term follow-up study was performed on 74 patients with rheumatoid arthritis (RA) treated with Charnley total hip arthroplasties (THAs), and compared with results for 142 patients with osteoarthritis (OA) . The follow-up term was very similar for the two groups (12.3 versus 13.4 years on average, respectively) . The preoperative score for 34 hips, according to the Japanese Orthopaedic Association (JOA), improved from 34.7 to 64.9 points at the final evaluation in the RA group, while that for 109 hips improved from 43.5 to 79.7 points in the OA group. Clinical results of the RA group were significantly worse than those of the OA group, but 25 patients (93%) of the RA group retained practical mobility. Radiological assessment showed high incidence of mechanical loosening in the RA group (41%), with 16% in the OA group. Migration of the socket in the RA group was more frequent in 10 hips (29%), and there was stem loosening in 4 hips (12%) . In addition to poor bone quality, protrusio acetabuli seemed to be one of the significant causes of socket migration. Although 81% of the RA group had multiple joint replacements in the lower extremity (mean, 2.6 arthroplasties), such procedures did not worsen the clinical results of the THA. In spite of the high incidence of mechanical loosen-ing, the Charnley THA was very useful for pain relief and maintenance of practical mobility for more than 10 years.
日本関節病学会の論文