Total hip arthroplasty in Paget's disease. A follow-up note.

In eighty patients who were seen with Paget's disease of the hip between 1969 and 1982, symptomatic coxarthrosis led to total hip arthroplasty in ninety-one hips. The long-term clinical and radiographic results were analyzed by use of the Mayo Clinic hip-scoring system. The cases of the forty-six patients (fifty-two hips) who had been operated on before 1975 were analyzed ten years after the arthroplasty. In this group, the incidence of aseptic loosening that required revision was approximately 15 per cent; radiographic evidence of loosening was evident in approximately 30 per cent of the femoral components and approximately 14 per cent of the acetabular components. Actuarial analysis comparing these forty-six patients with our over-all experience of total hip arthroplasty during the same period of time in 7,222 hips of patients who did not have Paget's disease revealed an increase of slight statistical significance in the incidence of revision for aseptic loosening in the patients who had Paget's disease. However, the over-all result was good or excellent in 74 per cent of these patients, suggesting that replacement of the hip using cemented components remains an acceptable form of treatment for degenerative coxarthrosis secondary to Paget's disease.