The Journal of Bone and Joint Surgery, Vol 69, Issue 6 807-814, Copyright © 1987 by Journal of Bone and Joint Surgery, Inc
Hip arthroplasty in patients with systemic lupus erythematosus
AD Hanssen, ME Cabanela and CJ Michet
Forty-three prosthetic hip replacements (twenty-nine conventional total hip
replacements and fourteen bipolar endoprosthetic replacements) were
implanted between January 1971 and June 1982 in thirty-one patients who had
systemic lupus erythematosus. All but four patients had stage-III or IV
osteonecrosis of the femoral head. The median age at operation was
forty-three years, and the median length of follow-up was fifty-seven
months. Ratings were good or excellent for all but three total hip
arthroplasties at a mean of sixty-six months of follow-up. Complications
included delayed wound-healing (in approximately 15 per cent) and
superficial wound infection (in approximately 10 per cent). The occurrence
of these complications could not be correlated with the use of
corticosteroids at the time of the operation. Twenty-five per cent of the
patients, who were a mean of forty-three years old at operation, died less
than five years postoperatively from complications related to systemic
lupus erythematosus. Conclusions regarding the systemic effects of hip
arthroplasty in patients with systemic lupus erythematosus could not be
drawn on the basis of this study. Total hip arthroplasty uniformly provided
a good or excellent result in patients of all ages who had systemic lupus
erythematosus at a mean length of follow-up of sixty-six months. An
increased incidence of local wound complications, which were unrelated to
the use of corticosteroids, should be expected in patients with systemic
lupus erythematosus who undergo prosthetic arthroplasty of the hip.
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