Uncemented Total hip Replacement for Avascular Necrosis in Systemic Lupus Erythematosus.

초록

Objective: To evaluate the short and medium term results of total hip arthroplasty(THA) for avascular necrosis in patients with systemic lupus erythematosus(SLE). Method: Seven patients with SLE and avascular necrosis of the femoral head(AVNFH), who underwent 11 THA were retrospectively reviewed with a minimum follow up of 2 years. To determine whether these patients had results similar to those of patients with other condition, we formed a control group of 11 patients who had 11 THA. They were matched for age, sex, BMI, activity, follow-up period, type of implant with SLE. Control group had THA for primary osteoarthritis(n=1), secondary osteoarthritis(n=7), post-traumatic AVNFA(n=3) . The clinical and radiolographic results were evaluated by Harris hip score(HSS), thigh pain and serial radiographic findings, respectively. Results: All patients were female. Mean age at the index operation was 41.5 years(range, 20-57) and average follow-up period was 38.8 months (range, 24- 72), similar in both group. THA was performed with uncemented acetabular cup and femoral stem. There was no complication during the perioperative period. In the SLE group, HHS was from 68.3 (range 52 to 82) preoperatively to 97.5 (range, 96 to 99) at last follow-up. In the matched group, HHS was from 70.2 (range 58 to 86) preoperatively to 97.9 (range, 96 to 99) at last follow-up. On the last roentgenograms, none of acetabular components demonstrated any evidence of migration, tilt, rotation or shedding of metal particles in both groups. All femoral components demonstrated no evidence of subsidence, pedestal, or shedding of metal particles in both groups. Conclusion: In short and medium term, patients with SLE and AVN had excellent results after THA. Results were similar in patients who had hip replacement for other diagnoses. Therefore, it is considered that uncemented THA was useful treatment method for the patient who had SLE and AVN.