Summary
We examined 40 patients (12 men, 28 women) who had undergone hip arthrodesis for severe osteoarthritis more than 15 years previously. Twenty-one cases were due to congenital dislocation of the hip. The age at fusion was mostly between 30 and 39 years. There was no case in which the position of fusion was unsatisfactory. At follow-up, 26 patients had back pain, 9 had pain in the same knee, 2 in the opposite knee and 3 had pain in both knees. Pain in the opposite hip occurred in 5 patients who had slight osteoarthritic changes on the preoperative radiographs. Every patient had been able to return to his or her previous occupation. Thirty-five had some difficulty in bending during Japanese-style sitting, but all could walk for more than 30 minutes without any difficulty. All but two were satisfied with the operation and none of them wanted to have a total hip replacement. In spite of the disadvantages of arthrodesis of the hip, such as the limitation of some activities and the effect on neighbouring joints, most patients were very satisfied with the result.
Résumé
Dans cette étude rétrospective, nous avons examiné, cliniquement et radiologiquement, 40 sujets (12 hommes et 28 femmes) ayant subi une arthrodèse de hanche plus de 15 ans auparavant, 21 de ces cas étaient des ostéoarthrites secondaires à une luxation congénitale de la hanche. Au moment de l'intervention, la plupart des patients étaient âgés d'une trentaine d'années. Chez aucun d'entre eux la position de fusion n'était incorrecte. 26 patients se plaignaient de douleurs lombaires, 9 de douleurs du genou homolatéral, deux de douleurs du genou controlatéral et trois de douleurs des deux genoux. 5 patients, qui présentaient des lésions arthrosiques radiologiques avant l'intervention, signalaient des douleurs de la hanche controlatérale. Les altérations radiologiques des articulations adjacentes étaient relativement modestes après l'intervention. Tous les patients ont pu reprendre leurs activités. Trente-cinq éprouvaient des difficultés à s'accroupir à la manière japonaise, mais tous pouvaient marcher pendant plus de 30 minutes sans difficulté. A l'exception de deux cas, les patients étaient satisfaits des résultats de leur opération, aucun n'a exprimé le désir de bénéficier d'une arthroplastie totale. En dépit des désavantages de l'arthrodèse de la hanche vis à vis des articulations adjacentes et de certains actes de la vie quotidienne, la majorité des opérés jugeaient leur état tout à fait satisfaisant.
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Sofue, M., Kono, S., Kawaji, W. et al. Long term results of arthrodesis for severe osteoarthritis of the hip in young adults. International Orthopaedics 13, 129–133 (1989). https://doi.org/10.1007/BF00266374
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DOI: https://doi.org/10.1007/BF00266374