Analysis of Functional and Radiological Outcome of Total Hip Replacements in Rheumatoid and Osteoarthritis Patients*

Abstract

Introduction: Outcomes of total hip arthroplasties in rheumatoid are commonly considered as poor and with high rates of complication. Keeping in mind these conflicts of opinions we are going to analyse the functional and radiological outcomes of total hip arthroplasty between osteoarthritis and rheumatoid arthtitis. Patients and Method: Retrospective midterm study of thirty four patients who underwent total hip replacement in Sri Ramachandra medical center for rheumatoid and osteoarthritis (primary and secondary). Of the 44 hips, the indications are rheumatoid arthritis in 20 patients and osteoarthritis in 24 patients. We used the Harris hip score (Modified) for clinical and functional evaluation and plain X-ray pelvis with both hips and proximal femur—AP view and X-ray of the operated hip lateral view for radiological evaluation. Mean follow up is 9 years (8-13 years). Results: The mean pre and latest harris hip score are 44 and 88 respectively. The mean harris hip score in 1st, 3rd and 5th years are 86, 87 and 87 respectively. The mean pre and latest harris hip score in osteoarthritis is 49 and 92, in rheumatoid arthritis is 35 and 74. Conclusion: The results in patients who underwent total hip replacement for osteoarthritis are better than those for rheumatoid arthritis, however the gain in harris hip score is the same. As far as complications are concerned there is no difference between rheumatoid and osteoarthritis. Complications are mostly due to the faulty technique. Both uncemented and cemented total hip replacement give good results in non traumatic indications. In bilateral hip diseases there is considerable pain relief and improvement after the first THR, but the optimal improvement is not seen until the second replacement.