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Conversion of hip fusion to total hip arthroplasty: clinical, radiological outcomes and complications in 40 hips

  • Hip Arthroplasty
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Objective

The purpose of this retrospective study is to report the clinical and radiological outcome of total hip arthroplasty in patients with previous hip arthrodesis.

Patients and methods

We retrospectively reviewed 28 (40 hips) prospectively followed patients in whom ankylosed hips were converted to total hip arthroplasty (THA) between 2010 and 2014 in our institution. The average age at the time of the conversion operation was 40.8 ± 9.8 years (range 24–62). The ankylosis had lasted 20.4 ± 13.0 years (range 3–56) before conversion surgery. The etiology of the ankylosis was septic arthritis in 10 (25%), post-traumatic hip osteoarthritis in 8 (20%), developmental hip dysplasia in 6 (15%), rheumatoid arthritis in 6 (15%), primary osteoarthritis in 5 (12.5%) and ankylosing spondylitis in 5 (12.5%) hips. The indications for arthroplasty were intractable low back pain in 14 (50%), hip pain in 24 (85.7%), and ipsilateral knee pain in 19 (67.8%) patients. Harris Hip Score (HHS) was used to rate the clinical results before and after the surgery. Radiographic evaluations included component malposition and loosening. All complications during the study period were recorded.

Results

The mean follow-up period was 39.9 ± 10.6 months (range 24–60). The mean preoperative HHS was 33.3 ± 8.6 (range 18–50) and the mean HHS at the final follow-up was 74.9 ± 8.6 (range 52–97). There was a statistically significant increase in HHS (p = 0.0001). HHS was excellent in 1, good in 6, fair in 14 and poor in 7 patients. Increase in HHS was lower than 20 points in one patient (18 points), and one patient required two-staged exchange procedure due to deep infection. Thus, according to our success criteria (increase in HHS more than 20 points, radiographically stable implant, and no further surgical reconstruction), 92.8% (26/28) of patients had benefit from the surgery. Trendelenburg sign was positive in 12 hips. There was limb length inequality in 11 patients (mean 0.5 cm, range 1–3 cm). No patients had heterotopic ossification, sciatic nerve palsy or dislocation. There were five intra-operative fractures of the greater trochanter that were treated with cable wiring. One patient had trochanteric avulsion injury and was treated with trochanteric grip and cables. One patient (2.5%) had deep infection one year after the conversion THA and was treated with two-staged exchange procedure.

Conclusion

Conversion hip arthroplasty is an effective treatment method which provides functional recovery and patient satisfaction. However, a proper surgical technique and planning is necessary to minimize the complications.

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References

  1. Kirkos JM, Papavasiliou KA, Kyrkos MJ, Sayegh FE, Kapetanos GA (2008) The long-term effects of hip fusion on the adjacent joints. Acta Orthop Belg 74(6):779–787

    PubMed  Google Scholar 

  2. Lubahn JD, Evarts CM, Feltner JB (1980) Conversion of ankylosed hips to total hip arthroplasty. Clin Orthop Relat Res 153:146–152

    Google Scholar 

  3. Schafroth MU, Blokzijl RJ, Haverkamp D, Maas M, Marti RK (2010) The long-term fate of the hip arthrodesis: does it remain a valid procedure for selected cases in the 21st century? Int Orthop 34(6):805–810

    Article  PubMed  Google Scholar 

  4. Swanson MA, Huo MH (2011) Total hip arthroplasty in the ankylosed hip. J Am Acad Orthop Surg 19(12):737–745

    Article  PubMed  Google Scholar 

  5. Stover MD, Beaulé PE, Matta JM, Mast JW (2004) Hip arthrodesis: a procedure for the new millennium? Clin Orthop Relat Res 418:126–133

    Article  Google Scholar 

  6. Beaulé PE, Matta JM, Mast JW (2002) Hip arthrodesis: current indications and techniques. J Am Acad Orthop Surg 10(4):249–258

    Article  PubMed  Google Scholar 

  7. Sponseller PD, McBeath AA, Perpich M (1984) Hip arthrodesis in young patients: a long-term follow-up study. J Bone Joint Surg Am 66(6):853–859

    Article  CAS  PubMed  Google Scholar 

  8. Hardinge K, Williams D, Etienne A, MacKenzie D, Charnley J (1977) Conversion of fused hips to low friction arthroplasty. J Bone Joint Surg Br 59(4):385–392

    PubMed  Google Scholar 

  9. Kim YH, Oh SH, Kim JS, Lee SH (2003) Total hip arthroplasty for the treatment of osseous ankylosed hips. Clin Orthop Relat Res 414:136–148

    Article  Google Scholar 

  10. Rutz E, Schäfer D, Valderrabano V (2009) Total hip arthroplasty after hip joint ankylosis. J Orthop Sci 14(6):727–731

    Article  PubMed  Google Scholar 

  11. Schäfer D, Dick W, Morscher E (2000) Total hip arthroplasty after arthrodesis of the hip joint. Arch Orthop Trauma Surg 120(3–4):176–178

    PubMed  Google Scholar 

  12. Hamadouche M, Kerboull L, Meunier A, Courpied JP, Kerboull M (2001) Total hip arthroplasty for the treatment of ankylosed hips: a five to twenty-one-year follow-up study. J Bone Joint Surg Am 83-A(7):992–998

    Article  CAS  PubMed  Google Scholar 

  13. DeLee JG, Charnley J (1976) Radiological demarcation of cemented sockets in total hip replacement. Clin Orthop Relat Res 121:20–32

    Google Scholar 

  14. Gruen TA, McNeice GM, Amstutz HC (1979) “Modes of failure” of cemented stem-type femoral components: a radiographic analysis of loosening. Clin Orthop Relat Res 141:17

    Google Scholar 

  15. Callaghan JJ, Brand RA, Pedersen DR (1985) Hip arthrodesis: a longterm follow-up. J Bone Joint Surg Am 67:1328–1335

    Article  CAS  PubMed  Google Scholar 

  16. Idulhaq M, Park KS, Diwanji SR, Yoon TR, Wie JS (2010) Total hip arthroplasty for treatment of fused hip with 90° flexion deformity. J Arthroplasty 25:498–502

    Article  PubMed  Google Scholar 

  17. Peterson ED, Altenburg A, Nemanich JP, Cabanela ME (2009) Hip arthroplasty after previous arthrodesis. Clin Orthop Relat Res 467(11):2880–2885

    Article  PubMed  PubMed Central  Google Scholar 

  18. Villanueva M, Sobrón FB, Parra J, Rojo JM, Chana F, Vaquero J (2013) Conversion of arthrodesis to total hip arthroplasty: clinical outcome, complications, and prognostic factors of 21 consecutive cases. HSS J 9(2):138–144

    Article  PubMed  PubMed Central  Google Scholar 

  19. Kilgus DJ, Amstutz HC, Wolgin MA, Dorey FJ (1990) Joint replacement for ankylosed hips. J Bone Joint Surg Am 72A:45–54

    Article  Google Scholar 

  20. Reikeras O, Bjerkreim I, Gundersson R (1995) Total hip arthroplasty for arthrodesed hips: 5- to 13-year results. J Arthroplasty 10:529–532

    Article  CAS  PubMed  Google Scholar 

  21. Amstutz HC, Sakai DN (1975) Total joint replacement for ankylosed hips. Indications, technique, and preliminary results. J Bone Joint Surg Am 57(5):619–625

    Article  CAS  PubMed  Google Scholar 

  22. Perugia L, Santori FS, Mancini A, Manili M, Falez F (1992) Conversion of the arthrodesed hip to a total hip arthroplasty: indications and limitations. Ital J Orthop Traumatol 18:145–153

    CAS  PubMed  Google Scholar 

  23. Fernandez-Fairen M, Murcia-Mazón A, Torres A, Querales V, Murcia A (2011) Is total hip arthroplasty after hip arthrodesis as good as primary arthroplasty? Clin Orthop Relat Res 469(7):1971–1983

    Article  PubMed  Google Scholar 

  24. Baird EO, Kang QK (2009) Prophylaxis of heterotopic ossification—an updated review. J Orthop Surg Res 4:12. doi:10.1186/1749-799X-4-12

    Article  PubMed  PubMed Central  Google Scholar 

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Authors and Affiliations

  1. Orthopedics and Traumatology Clinic, Ortopedia Private Hospital, Adana, Turkey

    Mustafa Celiktas, Cagri Ors & Emre Togrul

  2. Department of Orthopedics and Traumatology, Antalya Education and Research Hospital, Soguksu Mah. Kazım Karabekir cd. Muratpaşa, Antalya, Turkey

    Ozkan Kose, Adil Turan & Ferhat Guler

Authors
  1. Mustafa Celiktas
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  2. Ozkan Kose
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  3. Adil Turan
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  4. Ferhat Guler
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  5. Cagri Ors
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Correspondence to Ozkan Kose.

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Celiktas, M., Kose, O., Turan, A. et al. Conversion of hip fusion to total hip arthroplasty: clinical, radiological outcomes and complications in 40 hips. Arch Orthop Trauma Surg 137, 119–127 (2017). https://doi.org/10.1007/s00402-016-2597-3

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  • DOI: https://doi.org/10.1007/s00402-016-2597-3

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