Hemopoietic stem cell transplantation in refractory rheumatoid arthritis is not a contraindication for reconstructive surgery

Hemopoietic stem cell transplantation (HCST) is an experimental therapy that may produce prolonged remissions in patients with rheumatoid arthritis (RA) resistant to other treatments. Prosthetic articular replacement is often required in severe long-lasting disease. There is a well-founded concern regarding the feasibility, and safety of reconstructive surgery after HSCT and as yet no published data on the subject. We report a patient with RA of 9 years' duration resistant to conventional treatments plus femoral head necrosis, who underwent prosthetic hip replacement with no post-surgical complications one year after HSCT with a sustained reponse.