Results of total hip arthroplasty in patients who have rapidly progressive hip disease: a systematic review of the literature

Abstract

Rapidly progressive hip disease is a rare condition characterized by rapid joint space narrowing (>2 mm in 1 year), chondrolysis and destruction of the femoral head. Although the etiology and pathogenetic mechanism is unclear, subchondral insufficiency fractures in the setting of physiologically weakened bone has recently been implicated as the primary insult. The standard of care has been total hip arthroplasty; however, there is a theoretical risk that the disease process may continue, placing the prosthesis at risk. In order to determine the clinical outcomes and implant survivorship in this population, a systematic search of the literature was conducted. Midterm (mean: 5 years) results following total hip arthroplasty demonstrated mean good-to-excellent clinical results (clinical hip scores >80 points) and a 3% revision rate, making this a valuable treatment option for patients who have rapidly progressive hip disease. The underlying disease process does not appear to compromise implant longevity.

Keywords::

• osteonecrosis
• rapidly progressive hip arthritis
• rapidly progressive hip disease
• rapidly progressive osteoarthritis
• subchondral fracture
• survivorship
• total hip arthroplasty

Financial & competing interests disclosure

MA Mont is a consultant for Stryker Orthopaedics and Janssen Research and Development, and receives research or institutional support from Stryker Orthopaedics, the NIH (NIAMS and NICHD) and Tissue Gene. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.