Rapidly Destructive Arthropathy Of The Hip: A Case Series Based On The Egyptian Community Arthroplasty Register

Abstract

Purpose of study: Rapidly destructive arthropathy (RDAH) of the hip is a poorly diagnosed condition. Its outcome is lacking in the literature, especially in developing countries. This study aims to evaluate the outcomes of Total Hip Replacement (THR) in RDAH in low-income settings, looking at survival, function and complications.

Methods: Review of the Egyptian Community Arthroplasty Register (ECAR) from 2007 to 2022, identified 15 hips with RDAH in 12 patients (3 bilateral). The mean age was 57 years old. Rapid progression of hip pain and disability was a consistent clinical feature, mean duration of symptoms was 6.25 months ranged from 2 to 12 month. All patients had undergone THR.,

Results: During the period of follow up (average 11.5 years), 80 % of patients had no complications, while one patient experienced dislocation, one patient with per- prosthetic fracture of greater trochanter and another had loosening requiring revision surgery. The Harris Hip Score significantly improved from 36.75 preoperatively to 77.33 postoperatively (p<0.001). All patients proved to be RDAH, as there was no evidence of other causes for rapid destruction such as Charcot, infection or cancer either preoperatively or at the end of follow up.

Conclusion: Although THR for RDAH is a complex procedure, the complication rate was nearly comparable to straight forward THR within literature. It appears that going for hip arthroplasty for RDAH without full investigation is an appropriate decision.