Journal
MODERN RHEUMATOLOGY
Volume 27, Issue 4, Pages 598-604Publisher
TAYLOR & FRANCIS LTD
DOI: 10.1080/14397595.2016.1256024
Keywords
Cementless total hip arthroplasty; Long-term results; Mortality; Rheumatoid arthritis
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Funding
- Japan Society for the Promotion of Science [15K10450]
- Chugai Pharmaceutical
- Takeda Pharmaceutical
- Mitsubishi-Tanabe Pharma
- Janssen Pharmaceutical
- Pfizer
- Eisai
- AbbVie
- Bristol-Myers
- Astellas
- Santen
- Grants-in-Aid for Scientific Research [15K20023, 16H03170] Funding Source: KAKEN
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Objectives: To retrospectively evaluate the long-term results of cementless total hip arthroplasty (THA) in patients with rheumatoid arthritis (RA) and postoperative patient mortality after THA. Methods: This study included 191 hips in 149 RA patients who underwent cementless THA between 1998 and 2005. Mean age at surgery was 54.2 years, and mean follow-up was 12.6 years. Implant and patient survivorships were determined using the Kaplan-Meier method, and the associated influencing factors were determined. Results: Implant survivals at 17 years were 99.5% for stems, 93.9% for cups, and 90.8% for liners. Among the liners used, THAs with highly cross-linked polyethylene showed better survivals compared with those with conventional polyethylene and alumina-bearing surface (93.4%, 90.9%, and 52.2%, respectively). A total of 64 deaths occurred; 45 patients died within 10 years and 19 patients died between 10 and 17 years. Malignancy (25.0%) was the leading cause of death, followed by pneumonia (20.8%) and sepsis (20.8%). The patient survival rate was 36.9% at 17 years after THA. Multivariate analysis exhibited that older age at operation and greater dose of concomitant corticosteroid resulted in shorter patient survivals. Conclusions: Cementless THA worked well in patients with RA. Mortality remained high among RA patients who needed THA.
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