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AB0477 Comparative Analysis of the Faults, Complications, Follow up in Patients with Wide Spectrum for Rheumatic Diseases Attached to Total Hip Replacement
  1. V.P. Pavlov,
  2. S.A. Makarov
  1. Institute of Rheumatology RAMS, Moscow, Russian Federation

Abstract

Objectives The feasible of the total hip replacement (THR) in the wide spectrum rheumatic diseases with hip involvements, analysis of the faults, complications, preliminary follow up.

Methods The are 1069 patients, 773 women and 296 men (3,6:1), mean age 49,6 y. (16-83 y), 323 – rheumatoid arthritis (RA), 124 – juvenile rheumatoid arthritis (JRA), 80- ankylosing spondylitis (AS),79 – systemic lupus erythematosis (SLE), 11- systemic sclerodermia (SSD), 18- psoriatic arthropathy (PsA), 353 – osteoarthritis (OA), 21 – syndromes and methabolic diseases, 40 – spontaneous and traumatic cervical hip fractures in RA and senile patients. In total - 1201 THR including 135 double procedures.

Results Complications: mortality – 4 patients (0,37%) - from acute adrenal insufficiency-1, myocardium infarction-2, purulent bronchitis exacerbation-1.Thromboembolism of pulmonary artery branch-1 patient {0,083%), phlebothrombosis – 4 patients (0,37%) with satisfactory outcome after intensive anticoagulant therapy. Aseptic implant loosening - in one JRA patient over 9 post-up years with satisfactory result after revision surgery. Periprosthetic infection- in 9 cases (0, 74%) among them 3- early and 6 - late, from those 7- in RA, 1-SLE, 1–OA. The treatment: revision's debridement and intensive salvage therapy with implants preserved in one OA and removed in RA patients. 5 RA patients are need in repeated revision surgery. One RA patient died from diabetes. Preliminary follow up had valued before and 2-12 y (mean 4,6 y.) after THR by HHS in RA, JRA, SLE, AS, OA, PsA patients (n-173) as 32,3±3,8/81,7±8,6 points. Functional status and life quality had valued by index HAQ and enquire EQ-5D before and after THA – in RA, AS, OA patients (n-90) 1,81±0,2/0,88±0,2 and in RA, JRA, AS,OA patients (n-112) 0,06±0,06/0,65±0,07 correspondently.

Conclusions THR in patients of wide spectrum rheumatic diseases was accompanied by modest risk of peri- and postoperative complications. Preliminary follow up testified to essential improvement of operative joints, functional status and life quality in rheumatic patients.

Disclosure of Interest None declared

DOI 10.1136/annrheumdis-2014-eular.1672

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