Total hip replacement in adult patients with severe Kashin-Beck disease of the hip

BACKGROUND The treatment of elderly patients with Kashin-Beck disease (KBD) remains clinically challenging, and clinical data are very lacking. The aim of this study was to retrospectively evaluate pain and functional outcomes following total hip replacement in adult patients with severe KBD of the hip. METHODS Twenty-two patients (32 hips) with KBD underwent primary hip replacement and were followed for at least 2 years. Radiographic and Clinical assessments were evaluated for each patient at 2 and 4 weeks and at 3, 6 and 12 months after the operation and annually thereafter. The efficacy index included the visual analogue scale (VAS) score, Harris hip score, functional score for adult Tibetans with Kashin-Beck Disease (FSAT-KBD) and radiographic outcomes. RESULTS The patients underwent a follow-up, and the mean follow-up time was 3.8 years. VAS scores significantly decreased within the first 6 months postoperatively. This decrease continued until the final follow-up (p < 0.01). This result was supported by a significant increase in the Harris and FSAT-KBD scores after the surgery (p < 0.01). At the final follow-up, there was no change in prosthesis positioning or radiographic evidence of prosthesis loosening. One case received impacted allograft bone croutons and had worn polyethylene components replaced after 6 years because the patient suffered severe pelvic and femoral osteolytic lesions postoperatively. CONCLUSIONS Hip replacement can relieve pain and improve joint function in treating severe KBD hip. Additional studies that are more extensive are needed to confirm the findings of our study.