Imagama Takashi, Tokushige Atsunori, Seki Kazushige, Seki Toshihiro, Ogasa Hiroyoshi, Taguchi Toshihiko
Orthopedics. 2018 Nov 1;41(6):e772-e776. doi: 10.3928/01477447-20180828-06. Epub 2018 Sep 5.
Clinical outcomes of total hip arthroplasty for rheumatoid arthritis are reportedly worse than those of total hip arthroplasty for osteoarthritis of the hip. The authors examined pre- and postoperative factors associated with the modified Harris hip score (mHHS). Fifty-one joints of 48 rheumatoid arthritis patients who underwent total hip arthroplasty were studied retrospectively. The authors examined the correlation between preoperative rheumatoid arthritis disease activity (Disease Activity Score in 28 joints-C-reactive protein and C-reactive protein) and mHHS at 1 year after total hip arthroplasty. Furthermore, pre- and postoperative mHHS values were compared between patients with other affected joints and patients with no affected joints in the lower limbs. The mean mHHS improved to 73.5 points postoperatively from 36.4 points preoperatively. Preoperative Disease Activity Score in 28 joints-C-reactive protein and C-reactive protein values were negatively correlated with pre- and postoperative mHHS values. Preoperative mHHS was not significantly different between the affected and not affected groups; however, postoperative mHHS was significantly lower in the affected group than in the not affected group. Total hip arthroplasty showed good clinical results for rheumatoid arthritis at short-term follow-up. However, pre- and postoperative mHHS values were influenced by preoperative rheumatoid arthritis disease activity. Moreover, the presence of additional affected joints in the lower limbs preoperatively resulted in a lower postoperative mHHS. Unlike patients with osteoarthritis, patients with rheumatoid arthritis often have multiple affected joints, which may contribute to a lower mHHS. Comprehensive treatment, including surgery for the other affected joints in the lower limbs, may improve a patient's postoperative mHHS. [Orthopedics. 2018; 41(6):e772-e776.].
据报道，类风湿性关节炎全髋关节置换术的临床结果比髋关节骨关节炎全髋关节置换术的结果更差。作者研究了与改良Harris髋关节评分（mHHS）相关的术前和术后因素。对48例接受全髋关节置换术的类风湿性关节炎患者的51个关节进行了回顾性研究。作者研究了术前类风湿性关节炎疾病活动度（28个关节疾病活动评分- C反应蛋白和C反应蛋白）与全髋关节置换术后1年的mHHS之间的相关性。此外，比较了下肢有其他受累关节的患者和无受累关节的患者术前和术后的mHHS值。mHHS的平均值从术前的36.4分提高到术后的73.5分。术前28个关节疾病活动评分- C反应蛋白和C反应蛋白值与术前和术后mHHS值呈负相关。术前mHHS在受累组和未受累组之间无显著差异；然而，术后mHHS在受累组中显著低于未受累组。在短期随访中，全髋关节置换术对类风湿性关节炎显示出良好的临床效果。然而，术前和术后mHHS值受术前类风湿性关节炎疾病活动度的影响。此外，术前下肢存在额外的受累关节导致术后mHHS较低。与骨关节炎患者不同，类风湿性关节炎患者通常有多个受累关节，这可能导致mHHS较低。综合治疗，包括对下肢其他受累关节进行手术，可能会提高患者术后的mHHS。[《骨科》。2018；41(6):e772 - e776。]
