Outcome of total hip arthroplasty for avascular necrosis of femoral head in systemic lupus erythematosus patients: A comparative study

Background: Avascular necrosis (AVN) is a major cause of disability in systemic lupus erythematosus (SLE) patients which directly affects the functionality and quality of life. Total hip arthroplasty (THA) is indicated for severe cases with major disability and severe pain. It is still debatable if SLE is an independent risk factor for poor outcome in THA or not. Aim of the work: To evaluate the result of THA for AVN of the femur head in SLE patients. Patients and methods: 22 THAs were performed in 20 SLE patients and were compared with the results of 25 hips of 22 patients who had THA due to AVN with non-SLE conditions. All patients were followed up after the surgery at 6 weeks, 3, 6 and 12 months post-operatively, and then yearly for functional and radiological outcomes. Results: The Harris hip score (HHS) increased from a preoperative average of 26 points to 93.52 at the most recent follow-up. In the control group, the mean HHS was 26 preoperatively and 95.52 postoperatively at the last follow-up. Visual analog scale for pain (VAS pain) decreased from 8 in SLE and 6 in the non-SLE group to 2 and 1 respectively. No significant difference was found between SLE patients and nonSLE patients regarding complications except for more chest infections in the SLE group. No mortality was recorded in both groups in the postoperative follow-up period of a mean of thirty months. Conclusion: THA outcome is as favorable in AVN patients with SLE as in non-SLE. (c) 2021 THE AUTHORS. Publishing services by ELSEVIER B.V. on behalf of The Egyptian Society of Rheumatic Diseases This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/ licenses/by-nc-nd/4.0/).