REVIEW ARTICLE


The Hip in Juvenile Idiopathic Arthritis



Stuart B. Goodman, MD, PhD1, *
1 Departments of Orthopaedic Surgery and Bioengineering Stanford University School of Medicine 450 Broadway Street, Redwood City, CA, USA,


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Creative Commons License
© 2020 Goodman Stuart B.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Departments of Orthopaedic Surgery and Bioengineering Stanford University School of Medicine 450 Broadway Street, Redwood City, CA, USA, 94063 Tel:01-650-721-7662; Fax:01-650-721-3470; E-mail:goodbone@stanford.edu


Abstract

The hip joint is commonly affected in Juvenile Idiopathic Arthritis (JIA), especially in cases of systemic polyarticular disease. Chronic synovitis of the hip leads to joint destruction, therefore, systemic and local control of the disease is of paramount importance. Non-steroidal anti-inflammatory drugs, Disease Modifying Anti-Rheumatic Drugs (DMARDs), biologics, intra-articular corticosteroid injections, and physical therapy are the mainstay for controlling ongoing inflammation and hip joint contractures. Synovectomy with soft tissue releases is useful in the early stages of the disease, when the joint cartilage is largely preserved. Total joint arthroplasty (THA) is successful in relieving pain, and improving function, ambulation and range of motion in end-stage degenerative arthritis. With improved designs of smaller prostheses and modern bearing couples, it is hoped that the longevity of THA will facilitate a more normal and enduring lifestyle.

Keywords: Juvenile idiopathic arthritis, Juvenile rheumatoid arthritis, Hip, Inflammation, Replacement, Arthroplasty.