선천성 고관절 탈구증과 비구 이형성에서의 고관절 전치환술의 결과

김영민 ( Young Min Kim ),김희중 ( Hee Joong Kim ),강승백 ( Seung Baik Kang ),오주한 ( Joo Han Oh ) 대한고관절학회 1994 Hip and Pelvis Vol.6 No.2

We reviewed 18 total hip replacement arthroplasties for osteoarthrosis secondary to congenital hip dislocation and hip dysplasia. All arthroplasties were performed by the first author at our department from January 1976 to December 1992. All but two patient(3 hips) were female. The mean age of the patients at operation was 34 years (19 to 56). The mean leg length discrepancy was 4.2cm(1 to 7cm). Crowe grade of subluxation were grade I in 1 hip, grade g in 7 hips, grade g in 5 hips and grade IV in 5 hips. Acetabular wall reconstruction with bone graft was performed in 10 hips. The prosthesis used were Omnifit(Osteonics, U.S,A.) in 6 hips, PM type(Aesculap, Gennany) in 4 hips, Muller type(Zimmer, U.S.A.) in 4 hips, Euroform(Landos, France) in 1 hip, ABG(Howmedica, U.S.A.) in 1 hip and T-28(Zimmer, U.S.A.) in 1 hip. Preoperative traction and femoral shortening was done in 1 hip. Secondary operation was necessary after 2 weeks traction due to failed reduction. The mean fol- lowed-up period was 7 years and 11 months(1 year and 4 months to 18 years and 7 months). The mean Harris score was improved from 40 preoperatively to 85 postoperatively. Individual scores were beforesurgery: pain, 15(0 to 30); activity, 16(12 to 24); function, 8(6 to 10). At the time of review, the scores were; pain, 42(30 to 45); activity, 28(15 to 30); function, 12(10 to 14). On the femoral side, all showed no loosening and stable bony fixation was noted in cementless cases. Cups loosening were found in six hips and revision was performed in one hip of them. Two peroneal nerve palsies were occured: one after operation; another one during traction. At 7 years and 11 months of follow-up, clinically and radiologically satisfactory results were obatined in our study. However, cup loosening was noted in all cemented cup fixation cases which were performed before 1980. In cementless cup fixation cases even before the age of 45, no cup loosening was found. survival analysis with Kaplan-Meier showed the good results in cases using cementless and modern desinged prosthesis. Long term follow-up is mandartoy for the precise evaluation and anlysis of survival of hip arthroplasty.

65세 이상의 고령에서 사용한 세라믹-세라믹 관절면의 하이브리드형 인공 고관절 전치환술 -최소 5년 이상 추시 결과-

이송 ( Song Lee ),김진학 ( Jin Hak Kim ),고동오 ( Dong Oh Ko ),전영원 ( Young Won Jeon ),양승진 ( Seung Jin Yang ),류창욱 ( Chang Wook Ryu ) 대한고관절학회 2008 Hip and Pelvis Vol.20 No.2

목적: 65세 이상의 고령 환자에서 세라믹-세라믹 관절면을 이용하고 대퇴 스템만을 시멘트로 고정한 하이브리드형(Hybrid Type) 인공 고관절 전치환술의 최소 5년 이상의 추시 결과를 보고하고자 한다. 대상 및 방법: 1999년 2월부터 2002년 11월까지 65세 이상의 환자에게 시행한 세라믹-세라믹 관절면을 이용하고 대퇴 스템을 시멘트로 고정한 하이브리드형 인공 고관절 전치환술을 시행한 47명(47고관절) 중 5년 이상 추시가 가능한 29명(29고관 절)을 대상으로 하였다. 환자의 평균 연령은 68.9세(65~73세)였으며, 추시 관찰 기간은 평균 74.6 개월(61~107 개월)이었으며 최소 5년 이상 추시하였다. 대퇴 골두 무혈성 괴사가 21예, 퇴행성 고관절염 2예, 류마티스 관절염 1예, 대퇴 경부 골절 4예, 결핵성 고관절염 1예였다. 임상적으로는 Harris Hip Score(HHS)를 측정하고 서혜부 및 대퇴부 동통 유무를 평가하였고, 방사선 학적으로는 비구컵과 대퇴 스템 주변 각각의 골 용해, 응력차폐 효과에 의한 골흡수, 불안정성, 비구 전염각과 경사각, 경부 전염각 대퇴 스템의 고정 위치를 평가하였다. 결과: Harris 고관절 점수는 수술 전 56.3±1.4점에서 최종 추시시 92.3±1.1 점으로 향상되었고(p=0.013), 우수가 21 예 (72.4%), 양호가 8 예(27.6%) 였으며, 서혜부 및 대퇴부 동통은 없었다. 최종 추시 방사선 소견 상 비구컵과 대퇴 스템 주위 골용해가 발생한 경우는 한 예도 없었고, 응력 차폐 효과에 의한 골흡수 소견은 비구측 6예(20.7%), 대퇴부 3예(10.3%)에서 보였고, 안정성의 평가에서 비구컵은 모든 예에서 골성 안정성이였고, 대퇴스템은 1예(3.4%)에서만 가능성 해리를 보였다. 비구 전염각 평균은 18.4°±1.1, 경부 전염각 평균은 13.1°±0.9였고, 비구 경사각은 평균은 41.5°±1.3였고, 대퇴 스템은 모든 예에서 중립으로 삽입되었다. 합병증으로 고관절 후방 탈구는 1예(3.4%), 대퇴 삽입물 주위 골절이 1예(3.4%)였고 세라믹 관절의 파손은 없었다. 결론: 65세 이상의 고령에서의 세라믹-세라믹 관절면을 이용한 시멘트 인공 고관절 전치환술의 중기 추시 결과는 임상적, 방사선학적으로 만족할 만한 결과를 보였다. Purpose: This study examined the minimum five-year results of hybrid type total hip arthroplasty (THA) with ceramic-on-ceramic articulation and femoral stem fixation using cement in patients older than 65 years. Materials and Methods: From February 1999 to November 2002, a hybrid type THA with ceramic-on-ceramic articulation and femoral stem fixation using cement were performed in 47 patients (47 hips) older than 65 years of age. Among the 47 patients, 29 patients were followed up for more than 5 years. The mean age of these patients was 68.9 years (65~73years). The mean follow-up period was 74.6 months (61~107 months). The postoperative diagnosis included AVN of the femoral head in 21 hips, Osteoarthritis in 2 hips, rhematoid arhthritis in 1 hip, femoral neck fracture in 4 hips and Tuberculosis in 1 hip. The clinical results were analyzed retrospectively by the Harris hip score (HHS), hip and thigh pain, and radiologically by the level of osteolysis around acetabular cup and femoral stem, bone reabsorption by stress shielding, instability, acetabular and femoral stem anteversion, acetabular inclination and the femoral stem fixation site. Results: After surgery, the overall HHS improved from 56.3 ± 1.4 to 92.3 ± 1.1 points (p=0.013). Excellent and good results were obtained in 21 (72.4%) and 8 hips (27.6%), respectively. There was no case of thigh pain. Radiologically, there was no acetabular and femoral component osteolysis. Absorption by stress shielding was observed in 6 cases (20.7%) with an acetabular cup and 3 cases (10.3%) with a femoral stem. Bony stability was observed in all cases treated with an acetabular cup and possible loosening in 1 case (3.4%) treated with a femoral stem. Acetabular and femoral stem anteversion was 18.4°± 1.1 and 13.1°± 0.9 respectively. Acetabular inclination was 41.5°± 1.3. The femoral stem was inserted centrally in all cases. Complications included posterior dislocation of 1 hip (3.4%) and periprosthetic fracture of the femur in 1 hip (3.4%). There was no fracture of the ceramic component Conclusion: The mid-term results of hybrid type THA with ceramic-on-ceramic articulation and femoral stem fixation using cement were effective both clinically and radiologically in patients older than 65 years.

근위조립형 무시멘트 대퇴스템을 이용한 인공관절 재치환술

박명식 ( Myung Sik Park ),임영진 ( Yung Jin Lim ),이주홍 ( Ju Hong Lee ) 대한고관절학회 2006 Hip and Pelvis Vol.18 No.1

목적: 인공고관절 재치환술에 있어서 근위조립형 무시멘트 스템(Link MP hip reconstructive system)을 이용한 결과를 임상적 방사선학적 분석을 하고자 한다. 대상 및 방법: 1997년 1월부터 서 2002년 12월까지 인공관절 재치환술을 받은 환자 95명을 대상으로 하여 최소 24개월 최대 8년 4개월 이상 추시가 가능 하였던 57명 (57례)을 대상으로 하였다. 재치환술의 원인으로는 무균성이완이 45례, 감염성 이완으로 재-재치환경우가 5례, 대퇴스템과 관련된 골절이 6례, 재발성 탈구가 1례였다. 골결손의 정도는 Paprosky 분류에 의거하였으며 IIIA 이하가 46례, IIIB 이상이 11례였다. 결과: Harris hip score는 술 전 47에서 87.6으로 향상되었으며, 최종 추시상 환자의 만족도는 87.7%이며 원위 대퇴스템의 골형성에 의한 고정은 94.7%에서 관찰되었으며. 수술 중 합병증은 대전자부 골절 2례, 근위 대퇴골 골절이 2례였으며, 수술 후 합병증으로는 대퇴스템 침강이 5례(0-5 mm in 2hips, >20 mm in 3 hips), 심부 감염이 4례에서 관찰 되었으며, 대전자부 불유합과 동반된 아탈구 1례, 절골술 부위 불유합이1례, 고정나사의 이완이 1례에서 관찰 되었다. 근위-원위부품 모두 재치환은 20 mm이상 침강을 보인 3례중 2례에서 시행되었으며. 근위부품만을 교환한 경우는 3례로 불유합과 전자부 전위가 2례, 고정나사 이완1례였다. 최종추시상 대퇴스템 원위골절의 발생은 없었다. 결론: 인공관절 재치환술에서 근위 조립형 대퇴스템은 전염각 조정과 하지 길이의 조정이 편리하며, 감염 시 원위부 스템을 유지 한 채로 근위부만 단계적인 치환을 할 수 있었다. 조립형 재치환스템은 근위 대퇴골의 소실이 있는 증례에서 유용하게 사용 되었으며 보다 성공적인 결과를 얻기 위하여서는 섬세한 수술 수기와 합병증의 예방이 중요 할 것으로 사료 된다. Purpose: The goal of study was to evaluate the clinical and radiographic performance of the proximal modular cementless femoral stem for use in revision total hip arthroplasty. Material and method: Fifty seven patients (57 hips) were followed for longer than 24 months or up to 8.4 years after performing revision total hip arthroplasty with using the proximal modular cementless femoral stem between January 1997 and December 2002. The preoperative diagnosis included 45 cases of aseptic loosening, 5 cases of septic loosening (re-revision operation), 6 cases of periprosthetic fracture and 1 case of recurrent dislocation. The bone deficiencies were classified according to the Paprosky classification: there were 27 cases of Type I and II, 19 cases of Type IIIA, 9 cases of Type IIIB and 2 cases of Type IV. Results: The average Harris hip score improved from 47 to 87.6. Clinically satisfactory results were noted in 50 patients (87.7%). Radiographically, distal stable fixation was observed in 54 patients (94.7%). Intraoperative complications included two greater trochanteric fractures and two proximal femur fractures. Postoperative complications included 5 femoral stem subsidences (2hips< 5mm, 3 hips>20mm), 4 deep infections, 2 non-unions of the greater trochanter and the osteotomy site and set screw dissociation was noted in 1 case. 5 proximal component changes were done due to progressive subsidence in two cases, non-union at the osteotomy site and trochanteric displacement in two cases and set screw dissociation in one hip. For the infection cases, the proximal segment was removed and re-revised with a 2nd stage operation. (Ed note: check this.) The subsidence of the femoral stems was showed in 3 Paprosky grade IIIA cases and in 2 cases of grade IIIB or more. There was no postoperative periprosthetic fracture observed at the last follow-up. Conclusion: Revision total hip arthroplasty using the proximal modular cementless femoral stem showed good results in the face of the infection of the proximal component and deficient proximal bony support. This procedure appears to be convenient for the surgeon to correct anteversion of the femoral head and leg length discrepancy.

인공 고관절 재치환술에서 조립형 무시멘트 대퇴스템 사용 후 실패요인 분석

박종혁 ( Jong Hyuk Park ),박명식 ( Myung Sik Park ),김도연 ( Do Yeon Kim ) 대한고관절학회 2012 Hip and Pelvis Vol.24 No.2

목적: 인공 고관절 재치환술에서, 무시멘트형 조립형 대퇴스템으로 치료한 결과, 실패의 원인인자를 알아보고자 하였다. 대상 및 방법: 2년 이상 추시관찰이 가능하였던, 총 93명(100예)를 대상으로 하였다. 관찰대상은 남자 49명, 여자 44명 이었으며, 평균 연령은 62세(32-84세)였다. 임상적 결과는 Harris Hip Score로 평가하였으며, 재-재치환술의 실패의 변수로 수술의 회 수, 일차 스템의 시멘트 사용 여부, 골 결손과의 관계를 비교 하였다. 골 결손의 정도는 Paprosky 분류를 이용 하였으며, I과 II가 24예, IIIa가 45예, IIIb 가28예, IV가 3예였다. 결과: 임상결과는 수술 전 Harris Hip Score가 42점에서 술 후 평균 81.5점으로 증가하였다. 실패의 초기 원인으로는 대퇴스템 침강이 4예, 후기는 감염이 3예였다. 실패요인에 인자에 대한 분석으로 골결손(P=0.727), 시멘트 스템(P=0.087), 재수술의 횟수(P=0.024)를 변수로 분석하였다. 비교분석에서 재치환 수술의 횟수가 많을수록 실패율이 높았다(P=0.024). 결론: 인공 고관절 재치환술에서 조립형 스템은 만족할 만한 결과를 보였으나, 재수술 횟수가 많을수록 실패가 높았다. Purpose: The purpose of this study was to analyze failure rates and causes of hip arthroplasty revisions associated with the use of cementless modular femoral stems. Materials and Methods: This study comprised 93 patients(100 hips) that were followed up for more than two years after revision involving modular femoral stem arthroplasty. The clinical results were evaluated using the Harris Hip Score and the radiologic results were evaluated using leg length discrepancy, subsidence and bone formation assessments. We analyzed the relationship between the number of hip surgeries performed and the bone deficiencies and failures observed. Preoperative femoral bone deficiencies were described by Paprosky Grade; Grade I or II were identified in 24 hips, IIIa in 4 hips, IIIb in 28 hips and IV in 3 hips. Results: We observed 80 hips with aseptic loosening, 10 hips with infection after previous revision, 8 hips with periprosthetic fractures and 2 hips with dislocations. Clinical results improved from a preoperative score of 42 (HHS) to a postoperative mean score of 81.5. The cause of early failure in 4 hips was identified as femoral stem subsidence, and the cause of late failure in 3 hips was due to infection. According to the comparison analysis, there was no statistical significance between femoral bone deficiency (P=0.727) and application of cement (P=0.087), but hips with previous revision surgery showed a higher rate of failure (P=0.024). Conclusion: Cementless modular stems produced satisfactory results. The main cause of failure was subsidence. A significant risk factor for failure was hips which had undergone previous revision surgery.

Outcomes of Surgical Treatment of Periprosthetic Femoral Fractures in Cementless Hip Arthroplasty

김민욱,정영율,이정호,박지훈 대한고관절학회 2015 Hip and Pelvis Vol.27 No.3

Purpose: We aimed to evaluate the results of surgical treatment of periprosthetic femoral fractures in cementless total hip arthroplasty (THA). Materials and Methods: From June 2002 to May 2012, 40 patients who could be followed-up for more than 1 year after surgery were enrolled in this study. The mean duration of follow-up was 28.5 months (range, 15-97 months) and the average age at the time of surgery was 71.5 years (range, 38-89 years). The fracture types were determined by using the Vancouver classification. Among intraoperative fractures, there were type A in 3 hips, type B2 in 2 hips and type B3 in one. Among postoperative fractures, type AG was present in 5 hips, type AL in 2 hips, type B1 in 15 hips, type B2 in 6 hips, type B3 in 3 hips, and type C in 3 hips. Evaluation of the results was based on bony union, stability of the prosthesis, postoperative complications, and Harris hip score at the final follow-up. Results: Bony union was achieved in all but one case and the average time for bony union was 21 weeks. The mean Harris hip score was 86 at the final follow-up. Clinical results were above good in 34 of 40 hips (85.0%). Stem loosening occurred in one patient with a type B1 fracture treated with open reduction and plate fixation. Nonunion was observed in 1 patient with an AG type fracture. Conclusion: Open reduction and fixation using a plate with a screw and cerclage wiring provided good results for periprosthetic fractures in patients who had a stable femoral stem without bone defects. Revision surgery with a cementless long stem should be considered in patients with an unstable stem or suspected stability in B1 type of THA using a proximal fixation type.

Outcomes of Surgical Treatment of Periprosthetic Femoral Fractures in Cementless Hip Arthroplasty

( Min Wook Kim ),( Young Yool Chung ),( Jung Ho Lee ),( Ji Hoon Park ) 대한고관절학회 2015 Hip and Pelvis Vol.27 No.3

Purpose: We aimed to evaluate the results of surgical treatment of periprosthetic femoral fractures in cementless total hip arthroplasty (THA). Materials and Methods: From June 2002 to May 2012, 40 patients who could be followed-up for more than 1 year after surgery were enrolled in this study. The mean duration of follow-up was 28.5 months (range, 15-97 months) and the average age at the time of surgery was 71.5 years (range, 38-89 years). The fracture types were determined by using the Vancouver classification. Among intraoperative fractures, there were type A in 3 hips, type B2 in 2 hips and type B3 in one. Among postoperative fractures, type AG was present in 5 hips, type AL in 2 hips, type B1 in 15 hips, type B2 in 6 hips, type B3 in 3 hips, and type C in 3 hips. Evaluation of the results was based on bony union, stability of the prosthesis, postoperative complications, and Harris hip score at the final follow-up. Results: Bony union was achieved in all but one case and the average time for bony union was 21 weeks. The mean Harris hip score was 86 at the final follow-up. Clinical results were above good in 34 of 40 hips (85.0%). Stem loosening occurred in one patient with a type B1 fracture treated with open reduction and plate fixation. Nonunion was observed in 1 patient with an AG type fracture. Conclusion: Open reduction and fixation using a plate with a screw and cerclage wiring provided good results for periprosthetic fractures in patients who had a stable femoral stem without bone defects. Revision surgery with a cementless long stem should be considered in patients with an unstable stem or suspected stability in B1 type of THA using a proximal fixation type.

CLS Stem을 사용한 인공 고관절치환술에서의 임상적 결과

이중명 ( Joong Myung Lee ),조덕연 ( Duck Yun Cho ),구본섭 ( Bon Seop Koo ) 대한고관절학회 1993 Hip and Pelvis Vol.5 No.2

A retrospective clinical follow-up study was peiformed with clinical and radiological results of seventy total hip arthroplasties using CLS. Stem with minimum two-year follow-up (average 4.6 years). These included fiftyseven patients(forty-eight men, nine women), average age was forty-six. Most common indication was osteonecrosis, idiopat,hic and traumatic, 65. 7 percent. 25 Weill threaded cups, 20 bipolar cups, 20 expansion cups, and 5 hemispherical cups were used as an acetabular component. Clinical evaluation revealed average Harris hip score 94.6, mild thigh pain in 2 hips(2. 9%) and intermittent groin pain in 3 bipolar hips(4. 3%). Radiological evaluation revealed that mild calcar atrophy developed in 33 hips(47. 1%), cortical hypertrophy in 28 hips(40.0%). Significant radiolucent line in 2 of femoral components(2.9%) and in 1 of acetabular component(2.0%), significant position change(subsidence) in 2 of femoral components(2.9%) and in 2 of acetabular component(2.9%). And these also showed that spot welds adjacent to femoral prosthesie developed in 34 hips(48.6%), focal osteolysis, in 3 hips(4. 3%), varus shift, in 4 hips(5.7%) and subsidence, in 2 hips. Perioperative complications were 5 femoral splittings(7.1%) developed during the operation and 1 deep vein thrombosis(1.4%). Late postoperative complications were heterotrophic ossifications in 3 hips(4.3%) and trochanteric nonunion in 2 hips (2. 99o). We concluded that the clinical results of total hip arthroplasty with CLS stem were encouraging both clinically and radiologically. And these patients should be followed for more time period to evaluate appropriately.

The Effect of Hydroxyapatite Coating on Long-term Results of Total Hip Arthroplasty with Hydroxyapatite-coated Anatomic Femoral Stem

정영율,임채현,김대희,허주영,장영재 대한고관절학회 2014 Hip and Pelvis Vol.26 No.3

Purpose: To evaluate the clinical and radiological results, as well as the survival rate, associated with total hiparthroplasty using a hydroxyapatite (HA)-coated anatomical femoral stem at a follow-up of ≥12 years. Materials and Methods: From April 1992 to May 1997, 86 patients (102 hips) underwent total hip arthroplastywith a HA-coated ABG I (Anatomical Benoist Giraud; Howmedica) hip prosthesis. The average age at the timeof surgery was 53.4 years and the mean duration of follow-up was 17.1 years (range, 12.1-21.0 years). TheHarris hip score (HHS) and radiographic assessments of thigh pain were used to evaluate the clinical results. Weobserved osteointegration, cortical hypertrophy, reactive line, calcar resorption and osteolysis around the femoralstems. The survival rate of the femoral stems was evaluated by using the span of time to a revision operation forany reasons was defined as the end point. Results: The mean HHS was 50.5 preoperatively and 84.2 at the time of last follow-up. Osteolysis only aroundthe HA-coated proximal portion of the femoral stem was observed in 72 hips, cortical hypertrophy all around thedistal portion of the femoral stem was observed in 38 hips, and calcar resorption was observed in 44 hips. Areactive line was observed in 13 hips, but was unrelated to component loosening. Stem revision operations wereperformed in 24 (23%) hips due to osteolysis (14 hips), fracture (5 hips) and infection (5 hips). The femoral stemsurvival rate was 75% over the mean duration of follow-up. Conclusion: Total hip arthroplasty using a HA-coated anatomical femoral stem showed necessitated a high rateof revision operations due to osteolysis around the femoral stem in this long term follow-up study.

Hip&Pelvis : ORIGINAL ARTICLE : The Effect of Hydroxyapatite Coating on Long-term Results of Total Hip Arthroplasty with Hydroxyapatite-coated Anatomic Femoral Stem

( Young Yool Chung ),( Chae Hyun Im ),( Dae Hee Kim ),( Ju Yeong Heo ),( Young Jae Jang ) 대한고관절학회 2014 Hip and Pelvis Vol.26 No.3

Purpose: To evaluate the clinical and radiological results, as well as the survival rate, associated with total hip arthroplasty using a hydroxyapatite (HA)-coated anatomical femoral stem at a follow-up of ≥12 years. Materials and Methods: From April 1992 to May 1997, 86 patients (102 hips) underwent total hip arthroplasty with a HA-coated ABG I (Anatomical Benoist Giraud; Howmedica) hip prosthesis. The average age at the time of surgery was 53.4 years and the mean duration of follow-up was 17.1 years (range, 12.1-21.0 years). The Harris hip score (HHS) and radiographic assessments of thigh pain were used to evaluate the clinical results. We observed osteointegration, cortical hypertrophy, reactive line, calcar resorption and osteolysis around the femoral stems. The survival rate of the femoral stems was evaluated by using the span of time to a revision operation for any reasons was defined as the end point. Results: The mean HHS was 50.5 preoperatively and 84.2 at the time of last follow-up. Osteolysis only around the HA-coated proximal portion of the femoral stem was observed in 72 hips, cortical hypertrophy all around the distal portion of the femoral stem was observed in 38 hips, and calcar resorption was observed in 44 hips. A reactive line was observed in 13 hips, but was unrelated to component loosening. Stem revision operations were performed in 24 (23%) hips due to osteolysis (14 hips), fracture (5 hips) and infection (5 hips). The femoral stem survival rate was 75% over the mean duration of follow-up. Conclusion: Total hip arthroplasty using a HA-coated anatomical femoral stem showed necessitated a high rate of revision operations due to osteolysis around the femoral stem in this long term follow-up study.

류마티스관절염에서 시행한 고관절 표면 치환술

조윤제 ( Yoon Je Cho ),전영수 ( Young Soo Chun ),김강일 ( Kang Il Kim ),유기형 ( Kee Hyung Rhyu ),유명철 ( Myung Chul Yoo ),홍세혁 ( Se Hyuk Hong ) 대한류마티스학회 2011 대한류마티스학회지 Vol.18 No.2

Objective. This study analyzed the midterm results of hip resurfacing arthroplasty in patients with rheumatoid arthritis. Methods. Between October of 2003 and September of 2008, 13 consecutive hips that were treated with hip resurfacing arthroplasty due to rheumatoid arthritis were analyzed. The average follow up period was 48.6 months and the mean age at the time of operation was 35.9 years old. The mean BMI at the operation was 23.2 kg/m2. The implanted prostheses were the Conserve Plus system in five hips, the Birmingham hip resurfacing system in four hips and the Durom system in four hips. The results were clinically evaluated with the Harris hip score, the UCLA activity score, hip or thigh pain, the limb length discrepancy and the range of motion. As radiological evaluation, we observed the patterns of bone remodeling and complications such as femoral neck fracture, loosening and osteolysis. Results. The average Harris hip score improved from 62.2 to 98.9 at the final visit. The range of motion improved to 0˚ in flexion contracture, 118.1˚ in further flexion, 22.7˚ in internal rotation, 40.4˚ in external rotation, 28.8˚ in adduction and 38.1˚ in abduction, respectively. No patient complained of a limb length discrepancy and hip or thigh pain. Radiographically, impingement between the acetabular component and the femoral neck was observed in one case. However, radiographic findings such as osteolysis, radiolucency, wear and loosening were not observed. Conclusion. The midterm results of hip resurfacing arthroplasty in patients with rheumatoid arthritis were excellent. But long-term studies are needed to determine the survivorship and to evaluate the osteoporotic change, the metal ion level and their influence after hip resurfacing arthroplasty.