Archives of Orthopaedic and Trauma Surgery

, Volume 128, Issue 3, pp 249–254 | Cite as

Results of bilateral combined hip and knee arthroplasty in very young patients with juvenile rheumatoid arthritis

  • Kevin J. Mulhall
  • Khaled J. Saleh
  • Corey A. Thompson
  • Erik P. Severson
  • David H. Palmer
Orthopaedic Surgery
First Online:
Received:

Abstract

Introduction

We evaluated the long-term outcomes for combined, bilateral total knee and hip arthroplasty performed on a group of very young patients with juvenile rheumatoid arthritis.

Materials and methods

Six consecutive patients with a mean age of 14 years at the time of hip replacement and 16 years at knee replacement were analyzed. Five of the six patients were wheelchair dependent pre-operatively. All knee components had uncemented fixation, while the hip replacements were a mixed group of cemented and uncemented prostheses.

Results

Clinical and radiographic follow-up at a mean duration of 13.8 years for the hips and 17.3 years for the knees demonstrated four of the six patients were unlimited community ambulators, one a limited community ambulator and the remaining patient a household ambulator. Failure, defined as revision of any of the components or definite radiographic loosening, occurred in three knees (two patients) and five hips (three patients).

Conclusions

These good long-term functional results in a relatively very young population indicate that an early and aggressive approach to multiple joint disease is an appropriate option at a young age for patients with juvenile rheumatoid arthritis with severe disability and pain refractory to conservative management.

Keywords

Juvenile rheumatoid arthritis Knee arthroplasty Hip arthroplasty Survivorship Outcomes 
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Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  • Kevin J. Mulhall
    • 1
  • Khaled J. Saleh
    • 2
  • Corey A. Thompson
    • 3
  • Erik P. Severson
    • 4
  • David H. Palmer
    • 5
  1. 1.Department of Orthopaedic SurgeryMater Misericordiae University HospitalDublin 7Ireland
  2. 2.Department of Orthopaedic Surgery and Health Evaluative Sciences, Adult Reconstruction DivisionUniversity of VirginiaCharlottesvilleUSA
  3. 3.Department of Orthopaedic SurgeryUniversity of North Carolina at Chapel HillChapel HillUSA
  4. 4.University of UtahSalt Lake CityUSA
  5. 5.St. Croix OrthopaedicsStillwaterUSA

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