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Research Article

Survival of primary total hip arthroplasty in rheumatoid arthritis patients

Findings in 1,661 arthroplasties in 1,395 patients from the Danish Hip Arthroplasty Registry

, , , &
Pages 60-65 | Published online: 24 Feb 2010
 

Abstract

Background and purpose There has been a limited amount of research on survival of total hip arthroplasties (THAs) in rheumatoid arthritis (RA). We therefore performed a population-based, nationwide study to compare the survival of primary THAs in RA patients and in osteoarthritis (OA) patients. We also wanted to identify predictors of THA failure in RA patients.

Methods Using the Danish Hip Arthroplasty Registry, we identified 1,661 primary THAs in RA patients and 64,858 in OA patients, all of which were inserted between 1995 and 2008. The follow-up period was up to 14 years for both groups.

Results Regarding overall THA survival, the adjusted RR for RA patients compared to OA patients was 0.81 (95% CI: 0.65–1.01). We found no difference in survival of cups between primary THAs in RA and OA patients. In contrast, there was better overall survival of stems in RA patients than in OA patients, both regarding revision due to aseptic loosening (adjusted RR = 0.58; 95% CI: 0.34–0.99) and for any reason (adjusted RR = 0.63; 95% CI: 0.45–0.88). In RA patients, males had a higher risk of revision than females concerning aseptic loosening of the stem, any revision of the stem, and any revision of both components.

Interpretation The overall survival of primary THAs in RA patients is similar to THA survival in OA patients. Stem survival appeared to be better in RA patients, while survival of the total THA concept did not show any statistically significant differences between the two groups. In RA patients, males appear to have a greater risk of revision than females.

Acknowledgments

The authors thank all the orthopedic surgeons and departments in Denmark for contributing to the registration in the Danish Hip Arthroplasty Registry.

CRS participated in the design of the study, analysis of data, and in writing of the manuscript. ABP, SPJ, and SO contributed to the study design, analysis of data, and writing of the manuscript. AHR prepared the raw data and figures used in the study.

No competing interests declared.