RESEARCH - Results of bilateral combined hip and knee arthroplasty in very young patients with JRA

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Arch Orthop Trauma Surg. 2008 Mar;128(3):249-54. Epub 2007 Sep 15.

Results of bilateral combined hip and knee arthroplasty in very young

patients with juvenile rheumatoid arthritis.

Mulhall KJ, Saleh KJ, CA, Severson EP, Palmer DH.

Department of Orthopaedic Surgery, Mater Misericordiae University

Hospital, Eccles Street, Dublin 7, Ireland.

INTRODUCTION: We evaluated the long-term outcomes for combined,

bilateral total knee and hip arthroplasty performed on a group of very

young patients with juvenile rheumatoid arthritis.

MATERIALS AND METHODS: Six consecutive patients with a mean age of 14

years at the time of hip replacement and 16 years at knee replacement

were analyzed. Five of the six patients were wheelchair dependent

pre-operatively. All knee components had uncemented fixation, while

the hip replacements were a mixed group of cemented and uncemented

prostheses. RESULTS: Clinical and radiographic follow-up at a mean

duration of 13.8 years for the hips and 17.3 years for the knees

demonstrated four of the six patients were unlimited community

ambulators, one a limited community ambulator and the remaining

patient a household ambulator. Failure, defined as revision of any of

the components or definite radiographic loosening, occurred in three

knees (two patients) and five hips (three patients).

CONCLUSIONS: These good long-term functional results in a relatively

very young population indicate that an early and aggressive approach

to multiple joint disease is an appropriate option at a young age for

patients with juvenile rheumatoid arthritis with severe disability and

pain refractory to conservative management.

PMID: 17874245

http://www.ncbi.nlm.nih.gov/pubmed/17874245

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