Effectiveness of Total Hip Arthroplasty Combined With Hip Braces for Hip Charcot Arthropathy.

Abstract

Objective: Charcot arthropathy is characterized by varying degrees of sensory loss and rapidly progressive joint destruction. Historically, limited studies indicated that Charcot arthropathy of the hip joint may be a contraindication for total hip arthroplasty (THA). Yet, some recent studies have shown that good clinical results and acceptable survival rate. Hence, this study aimed to investigate clinical outcomes, radiographic outcomes, complication rates and survivorship of primary THA in Charcot arthropathy.

Methods: We retrospectively included 11 patients (11 hips) with Charcot arthropathy who underwent THA between 1998 and 2016. All involved patients were diagnosed as syphilis. All patients had classic radiographic findings of Charcot arthropathy. The hip braces were used in all patients for six weeks after surgery. Outcome measures included VAS, Oxford Hip Score, and UCLA score. Statistical analyses involved t-tests, chi-square tests, and Kaplan-Meier survival analysis.

Results: The average follow-up period was 81.73 months. The average VAS, Oxford Hip Score, and UCLA score were improved significantly. There was higher complication rate of 45.5% after THA. Reoperation was carried out in two patients due to dislocation and acetabular component loosening. The Kaplan-Meier survivorship with an end point of reoperation for any reason was 81.8%.

Conclusions: THA is proved to be reasonable in improving hip joint function, which is suitable for patients with Charcot hip joint. Although the complication rate is high, we consider that THA combined with hip brace may be a valid treatment choice for Charcot arthropathy with detailed preoperative planning and proper precautions.