HSS Journal

, Volume 5, Issue 2, pp 117–119 | Cite as

Total Hip Arthroplasty in Rapidly Destructive Osteoarthritis of the Hip: A Case Series

  • Alfred Kuo
  • Kace A. Ezzet
  • Shantanu Patil
  • Clifford W. ColwellJr.
Original Article

Abstract

Rapidly destructive osteoarthritis (RDO) of the hip is a rare condition characterized by rapid joint degeneration and destruction similar to findings of infection, osteonecrosis, or Charcot disease but without a definitive diagnosis. The cause and natural history of RDO are unclear, but total hip arthroplasty has been utilized as a treatment modality due to the severity of the symptoms. We reviewed retrospectively the records of total hip arthroplasties performed between 1990 and 2003 and identified ten hips in eight patients who fit the profile of the diagnosis of RDO. The mean age at time of surgery was 70. Nine hips were treated with total hip arthroplasty with a hybrid configuration; one hip was treated with a non-cemented total hip arthroplasty. Average follow-up was 6 years with no radiographic evidence of acetabular loosening or osteolysis and no evidence of asymmetric cup wear. One femoral component had evidence of loosening but has not been revised. RDO is an idiopathic condition with no single diagnostic laboratory, pathological, or radiographic finding. A complete preoperative work-up for other causes of hip disease prior to arthroplasty for suspected RDO is necessary to rule out treatable disease. Our series of patients with RDO responded well to hybrid and non-cemented total hip arthroplasty with good clinical and radiographic results.

Keywords

rapidly destructive osteoarthritis total hip arthroplasty level of evidence: IV—case series 

References

  1. 1.
    Flik K, Vargas JH 3rd (2000) Rapidly destructive hip disease: a case report and review of the literature. Am J Orthop 29:549–552PubMedGoogle Scholar
  2. 2.
    Lequesne M (1970) [Rapid destructive coxarthritis]. Rhumatologie 22:51–63PubMedGoogle Scholar
  3. 3.
    Postel M, Kerboull M (1970) Total prosthetic replacement in rapidly destructive arthrosis of the hip joint. Clin Orthop Relat Res 72:138–144PubMedGoogle Scholar
  4. 4.
    Rosenberg ZS, Shankman S, Steiner GC et al (1992) Rapid destructive osteoarthritis: clinical, radiographic, and pathologic features. Radiology 182:213–216PubMedGoogle Scholar
  5. 5.
    Charrois O, Kahwaji A, Rhami M et al (2002) Outcome after total hip arthroplasty performed for rapidly progressive hip destruction]. Rev Chir Orthop Reparatrice Appar Mot 88:236–244PubMedGoogle Scholar
  6. 6.
    Motomura G, Yamamoto T, Nakashima Y et al (2006) Outcome of the contralateral hip in rapidly destructive arthrosis after total hip arthroplasty: a preliminary report. J Arthroplasty 21:1026–1031PubMedCrossRefGoogle Scholar
  7. 7.
    Mohler CG, Kull LR, Martell JM, Rosenberg AG, Galante JO (1995) Total hip replacement with insertion of an acetabular component without cement and a femoral component with cement. Four to seven-year results. J Bone Joint Surg Am 77:86–96PubMedGoogle Scholar
  8. 8.
    Ishiguro N, Takagi H, Ito T et al (2001) Rapidly destructive arthropathy of the hip in haemophilia. Haemophilia 7:127–130PubMedCrossRefGoogle Scholar
  9. 9.
    Corra T, Zaccala M, Galante M (1995) Ochronotic arthropathy: rapid destructive hip osteoarthritis associated with metabolic disease. Clin Rheumatol 14:474–477PubMedCrossRefGoogle Scholar

Copyright information

© Hospital for Special Surgery 2009

Authors and Affiliations

  • Alfred Kuo
    • 1
  • Kace A. Ezzet
    • 2
  • Shantanu Patil
    • 3
  • Clifford W. ColwellJr.
    • 3
  1. 1.Department of Orthopaedic SurgeryUniversity of California and Surgical Service Department, Veterans Affairs Medical CenterSan FranciscoUSA
  2. 2.Division of Orthopaedic SurgeryScripps ClinicLa JollaUSA
  3. 3.Shiley Center for Orthopaedic Research and EducationScripps ClinicLa JollaUSA

Personalised recommendations