Bipolar hip arthroplasty in rheumatoid arthritis

Bipolar hip arthroplasty with bone grafting was performed on 25 joints with rheumatoid arthritis from 1981 to 1985. The results and roentgenographical progress of the grafted bone were followed for a minimum of two years, the longest follow-up examination occurring six years after the operation. The clinical score was assessed by the hip rating score of the Japanese Orthopaedic Association, which assigns a maximum of 100 points. The preoperative clinical score ranged from 22 to 59 points (mean, 42.6). The postoperative score improved to a range of 65-92 points (mean, 72.8). Of 24 hips examined, 21 (87.5%) were painless. As measured serially from the roentgenograms made immediately after the operation, the overall distance of central migration in 24 hips was 0-8.5 mm (average, 2.7 mm). The overall distance of superior migration in 24 hips was 0-10 mm (average, 3.7 mm). A single massive bone graft using extracted femoral head was considered to be better than bone fragments as the procedure for acetabular reconstruction during bipolar hip arthroplasty in rheumatoid arthritis.