Uncemented total hip arthroplasty in patients with rheumatoid arthritis

Total hip arthroplasty has become a successful way of treating the painful and destroyed hip joint in the patient with rheumatoid arthritis. Because of the underlying disease, it still is controversial whether the implants selected should be used with bone cement, or whether uncemented devices will give equally good results in this population. Fifteen patients suffering from rheumatoid arthritis underwent 21 hip arthroplasties. The followup period averaged 3.3 years (range, 2.5-6.8 years). All but one patient were taking medication at the time of surgery for their underlying disease. Clinical evaluation was based on a modified Harris hip score that showed significant improvement in pain and function preoperatively compared with pain and function at the most recent followup. Radiographic analysis revealed five cases of minor migration of the acetabular components, and three cases of distal migration of 2 mm or less in the femoral components. Complications consisted of heterotopic ossifications in one patient, and an intraoperative femoral fracture in one patient. There were no infections, and there were no deep vein thromboses. The results in these patients suggest that cementless total hip arthroplasty might become a successful way of treating the destroyed hip joint in the patient with rheumatoid arthritis.