ARE HIP-JOINT SYNOVECTOMIES AND ARTHROLYSES STILL MEANINGFUL IN THE PRESENT AGE OF ENDOPROSTHETICS

Between Jan. 77 and Jun. 88 511 surgical interventions were performed on the hip in rheumatoid patients-465 total hip replacements and 46 synovectomies, most in combination with arthrolysis in 42 patients. 32 hips in 29 patients with rheumatoid arthritis (at an average age of 32 years) were evaluated. All early performed synovectomies lead to an improvement of pain and disability, in 18 cases for 2 and more years. Further operations were necessary at an average of 2,7 years later in 14 hips (44%). 13 times total hip replacements and one time in another hospital a cup-arthroplasty. On the other side 18 cases (56%) had after an average duration of 5,8 years no need to undergo further surgical interventions. Since 1986 for complete synovectomy surgical dislocation of the hip joint was performed up to now without roentgenographic changes characteristic of avascular necrosis of femoral head. The total hip replacements in an osteoporotic bone of young rheumatic patients are over a long period not free of problems. The early performed synovectomy of the hip can wisely postpone the replacement.