Juvenile Rheumatoid Arthritis and Total Hip Arthroplasty

Juvenile rheumatoid arthritis (JRA) is the most common rheumatic disease of childhood. Hip joint involvement is the most significant factor impacting mobility and independence of the child. The persistent synovitis can lead to physeal growth injury and cartilage destruction. The first line of treatment involves anti-inflammatory medications, physiotherapy, and intra-articular injections. Surgical treatment options include soft tissue release of contractures, synovectomy, and joint arthroplasty. The results of joint replacement in this population are encouraging however there are many anatomical challenges in this population. The optimal method of fixation remains yet unclear.