The Journal of Bone and Joint Surgery, Vol 69, Issue 5 766-772, Copyright © 1987 by Journal of Bone and Joint Surgery, Inc
Total hip arthroplasty in Paget's disease. A follow-up note
DJ McDonald and FH Sim
In eighty patients who were seen with Paget's disease of the hip between
1969 and 1982, symptomatic coxarthrosis led to total hip arthroplasty in
ninety-one hips. The long-term clinical and radiographic results were
analyzed by use of the Mayo Clinic hip-scoring system. The cases of the
forty-six patients (fifty-two hips) who had been operated on before 1975
were analyzed ten years after the arthroplasty. In this group, the
incidence of aseptic loosening that required revision was approximately 15
per cent; radiographic evidence of loosening was evident in approximately
30 per cent of the femoral components and approximately 14 per cent of the
acetabular components. Actuarial analysis comparing these forty-six
patients with our over-all experience of total hip arthroplasty during the
same period of time in 7,222 hips of patients who did not have Paget's
disease revealed an increase of slight statistical significance in the
incidence of revision for aseptic loosening in the patients who had Paget's
disease. However, the over-all result was good or excellent in 74 per cent
of these patients, suggesting that replacement of the hip using cemented
components remains an acceptable form of treatment for degenerative
coxarthrosis secondary to Paget's disease.
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