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  • Title: Results of bilateral combined hip and knee arthroplasty in very young patients with juvenile rheumatoid arthritis.
    Author: Mulhall KJ, Saleh KJ, Thompson CA, Severson EP, Palmer DH.
    Journal: Arch Orthop Trauma Surg; 2008 Mar; 128(3):249-54. PubMed ID: 17874245.
    Abstract:
    INTRODUCTION: We evaluated the long-term outcomes for combined, bilateral total knee and hip arthroplasty performed on a group of very young patients with juvenile rheumatoid arthritis. MATERIALS AND METHODS: Six consecutive patients with a mean age of 14 years at the time of hip replacement and 16 years at knee replacement were analyzed. Five of the six patients were wheelchair dependent pre-operatively. All knee components had uncemented fixation, while the hip replacements were a mixed group of cemented and uncemented prostheses. RESULTS: Clinical and radiographic follow-up at a mean duration of 13.8 years for the hips and 17.3 years for the knees demonstrated four of the six patients were unlimited community ambulators, one a limited community ambulator and the remaining patient a household ambulator. Failure, defined as revision of any of the components or definite radiographic loosening, occurred in three knees (two patients) and five hips (three patients). CONCLUSIONS: These good long-term functional results in a relatively very young population indicate that an early and aggressive approach to multiple joint disease is an appropriate option at a young age for patients with juvenile rheumatoid arthritis with severe disability and pain refractory to conservative management.
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