Probable Place of Total Hip Arthroplasty in Rheumatoid Arthritis Involving the Hip

Abstract

Summary At the time of this writing our experience with total hip arthroplasty is entering its third year. We are using the Charnley low friction arthroplasty and feel confident in advising total hip arthroplasty to patients with rheumatoid arthritis. In rheumatoid arthritis and rheumatoid spondylitis involving the hips, this procedure gives the most predictable result for both relief of pain and restoration of function. Complications are considerably less than with any other surgical procedure used before for relief of pain and improvement of function; this would include cup arthroplasty and replacement of the femoral head. Special consideration must be given the rheumatoid patient because of the general nature of his disease and the involvement of multiple joints in most instances. Yet although this may preclude his ambulating as well as the patient with osteoarthritis, the rheumatoid patient is usually quite satisfied when he is able to move about as he wishes with little or no pain or when he can move even from bed to chair with greater ease than before the operation. We have operated on patients younger than 50 years of age, which is our standard lower age for total hip arthroplasty, because so many rheumatoid patients have involvement at a younger age and because of the severe crippling nature of the disease. The problem is usually bilateral. These patients tend to put less stress on their new hip joints than those with osteoarthritis.