Artrodiastase para o tratamento da rigidez do quadril na artrite reumatoide juvenil (ARJ): resultados preliminares

Abstract

Objective: To present the preliminary results of the use of hip arthrodiastasis in patients with juvenile rheumatoid arthritis and involvement of the hip joint. Methods: A prospective study of 12 patients (six boys and six girls) aged between eight and 18 years (mean 10.5 years). We used a monolateral external fixator that allows flexion and extension at the hip. The ex- ternal fixator was maintained for a period ranging from 78 to 90 days, with a mean of 86 days. Radiographic control was performed during surgery, weekly during the traction period, and every four weeks once this period was completed. The clinical evaluation of results included the degree of the pain and the degree of joint movement, measured and evaluatedpre- and post-operatively. The follow-up period ranged from 12 to 15 years, with a mean of 13 years. Results: The average pain score was nine (9) before surgery and four (4) in the postoperative period. There was no improvement in pain in two patients. The range of motion of the hip increased in all patients except two. Radiographic evaluation evidenced a2 mm increase in joint space, on average,that has remained postoperatively. There were no complications with this tech- nique. Only a loosening of the Schanz screws in the region of the iliac bone was observed in two patients. The surgical technique did not bring satisfactory results. Conclusion: The arthrodiastasis procedure is well suited for recovery of mobil- ity in animpairedand rigid hip joint, as occurs in patients with juvenile rheumatoid arthritis.