Total hip replacement using the McKee-Farrar prosthesis. In rheumatoid arthritis, Still's disease, and ankylosing spondylitis.

Severe destructive change in the hip joint is not infrequent in patients with long-standing rheumatoid arthritis and Still's disease. In ankylosing spondylitis, whether primary or secondary to other diseases such as Still's disease, there may be a bony fusion or destruction. Various types of hip arthroplasty have been carried out in the last 30 years (Smith-Petersen, 1939; Chamley, 1961). The earlier prostheses, such as those of Judet and Judet (1950) and Austin Moore (1952), produced encouraging results. The Austin Moore prosthesis and that of Thompson were associated with loosening of the stem and migration, the latter especially in rheumatoid arthritis (Moore, 1952; Thompson, 1952). The Judet prosthesis also suffered from structural failure. The mould or cup arthroplasty is used in many centres but is not entirely satisfactory because of further wear and migration. The total hip replacements of McKee-Farrar and of Charnley have produced better early results. In this type of operation both surfaces of the joint are replaced and cement is used to obtain firm fixation of the prosthesis to the bone. The purpose of this paper is to present the results of McKee-Farrar arthroplasty (McKee and WatsonFarrar, 1966) in patients suffering from rheumatoid arthritis, Still's disease, and ankylosing spondylitis, and to compare these with results obtained in degenerative joint disease of the hip.