To define the prevalence and pathological spectrum of femoral head osteonecrosis in patients with rheumatoid arthritis (RA) and to correlate its presence with disease related clinical and therapeutic factors.
A total of 545 primary total hip arthroplasties performed in 507 patients with RA were identified.
A historical review of each patient's rheumatoid disease and treatment as well as pathological review of each femoral head specimen was performed.
Osteonecrosis was identified in 66 specimens (12.1%) in one of 2 discrete forms.
Thirty-two specimens (5.9%) contained classic subchondral avascular necrosis.
Thirty-four specimens (6.2%) contained osteonecrosis in association with degenerative changes (within regions of sclerotic and ebumated subchondral bone). but not classic avascular necrosis.
Remaining femoral head specimens were characterized by inflammatory arthritis (431 specimens) or degenerative joint disease (48 specimens).
Corticosteroid therapy was used in 81% of patients with avascular necrosis and 68% with degenerative osteonecrosis.
This was significantly greater prevalence than in patients without osteonecrosis (33%). Average daily prednisone dosage was 8 mg and no association between dosage and the presence of osteonecrosis was identified.
No correlation between pathological findings and clinical disease severity was identified. (...)
Mots-clés Pascal : Polyarthrite rhumatoïde, Complication, Homme, Ostéonécrose aseptique, Tête fémorale, Histopathologie, Epidémiologie, Prévalence, Analyse corrélation, Symptomatologie, Traitement, Facteur risque, Corticostéroïde, Pièce opératoire, In vitro, Chirurgie orthopédique, Chronique, Membre inférieur, Fémur, Système ostéoarticulaire pathologie, Rhumatisme inflammatoire, Immunopathologie, Maladie autoimmune, Ostéopathie
Mots-clés Pascal anglais : Rheumatoid arthritis, Complication, Human, Aseptic osteonecrosis, Femoral head, Histopathology, Epidemiology, Prevalence, Correlation analysis, Symptomatology, Treatment, Risk factor, Corticosteroid, Surgical specimen, In vitro, Orthopedic surgery, Chronic, Lower limb, Femur, Diseases of the osteoarticular system, Inflammatory joint disease, Immunopathology, Autoimmune disease, Bone disease
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0433649
Code Inist : 002B15D. Création : 25/01/1999.