慢性関節リウマチにおける全人工股関節置換術長期成績に関する研究

A long-term follow up study was performed on 125 total hip replacements (THR) in 95 rheumatoid patients. The average follow up time was 8 years and 5 months, ranging from 5 to 17 years. Except in 26 cases of death or 9 incomplete histories at the follow-up, 62 cases were investigated both clinically and radiologically. For the operations, two types of prostheses (Charnley and C-Muller ) were used. According to the Japan Orthopaedic Association (JOA) hip score, the preoperative score improved from 32.9 to 57.1 points at the final postoperative evaluation. In the radiological assessment using the method by Nagaya and Uno, a clear zone was seen around the acetabular cup in 82.2% of the hips and around the femoral stem in 53.2%. Rate of loosening corresponding to stage Ⅲ and Ⅳ was 20.2% in the acetabular side and 32.9% in the femoral side. Charnley-type group was better than C-Muller type both in clinical and radiological assessments. Twelve cases had lost walking ability. As postoperative complications, deep infections occurred in 4 hips, femoral shaft fracture in 4 hips, dislocation in 1 hip and revision due to aseptic loosening in 4 hips. THR may be useful for rheumatoid patients and improve the quality of life in the case of long-term disease if careful pre-and post-operative care is provided.