Department of Orthopedic Surgery, Hanyang University Guri Hospital, Gyomoon-dong 249-1, Guri, Gyunggi-do, 471-701, South Korea.
Department of Orthopedic Surgery, Hanyang University Hospital, Seoul, South Korea.
Int Orthop. 2020 Jun;44(6):1047-1053. doi: 10.1007/s00264-020-04502-3. Epub 2020 Feb 19.
To compare the radiographic migration profiles of primary cementless total hip arthroplasty (THA) between patients with rheumatoid arthritis (RA) and those with osteoarthritis (OA).
A total of 197 patients (215 hips) who underwent cementless THA for RA or OA between January 2001 and January 2013 and followed up for a minimum of 5.5 years were included. Ninety-four RA patients (109 hips) were compared with 103 OA patients (106 hips). Radiological evaluation was performed for acetabular cup loosening, and cup migration was measured using Einzel-Bild-Röntgen-Analyse (EBRA) software. Multiple variables were assessed to identify influencing factors for cup migration.
Early cup migration was observed in 13 hips (11.9%) in the RA group and four hips (3.8%) in the OA group, showing a significant difference (p = 0.041). Acetabular cup loosening occurred in three cups (2.8%) in the RA group and in one cup (0.9%) in the OA group, showing no significant difference (p = 0.321). Total cup migration was higher in the RA group (2.62 mm) than in the OA group (1.44 mm, p = 0.005). Total cup migration was significantly higher in patients aged < 50 years than in those aged > 50 years (p = 0.005). Rheumatoid factor (RF) and anti-cyclic citrullinated peptide (anti-CCP) antibody influenced total cup migration. Patients with seropositive RA showed significantly higher total cup migration and early cup migration incidence than those with seronegative RA (p = 0.005, p = 0.038, respectively).
Acetabular cups in primary cementless THAs of RA patients were less stable in terms of cup migration compared with that of OA patients.
比较类风湿关节炎（RA）和骨关节炎（OA）患者初次非骨水泥全髋关节置换术（THA）的放射学迁移曲线。
共纳入 2001 年 1 月至 2013 年 1 月期间接受初次非骨水泥 THA 治疗的 RA 或 OA 患者 197 例（215 髋），随访时间至少 5.5 年。94 例 RA 患者（109 髋）与 103 例 OA 患者（106 髋）进行比较。采用单幅 X 线分析（EBRA）软件评估髋臼杯松动情况，并测量髋臼杯迁移。评估多个变量以确定影响髋臼杯迁移的因素。
RA 组 13 髋（11.9%）和 OA 组 4 髋（3.8%）出现早期髋臼杯迁移，差异有统计学意义（p=0.041）。RA 组 3 髋（2.8%）和 OA 组 1 髋（0.9%）出现髋臼杯松动，差异无统计学意义（p=0.321）。RA 组总髋臼杯迁移（2.62mm）高于 OA 组（1.44mm，p=0.005）。年龄<50 岁的患者总髋臼杯迁移明显高于年龄>50 岁的患者（p=0.005）。类风湿因子（RF）和抗环瓜氨酸肽（anti-CCP）抗体影响总髋臼杯迁移。血清阳性 RA 患者的总髋臼杯迁移和早期髋臼杯迁移发生率明显高于血清阴性 RA 患者（p=0.005，p=0.038）。
初次非骨水泥 THA 中，RA 患者的髋臼杯在髋臼杯迁移方面较 OA 患者更不稳定。
