Conversion of Arthrodesis to Total Hip Arthroplasty: Clinical Outcome, Complications, and Prognostic Factors of 21 Consecutive Cases

Manuel Villanueva, MD, PhD
Hospital General Universitario Gregorio Maranon, Spain

Francisco Borja Sobrón, MD
Hospital General Universitario Gregorio Maranon, Spain

Javier Parra, MD
Hospital General Universitario Gregorio Maranon, Spain

Jose Manuel Rojo, MD, PhD
Hospital General Universitario Gregorio Maranon, Spain

Francisco Chana, MD, PhD
Hospital General Universitario Gregorio Maranon, Spain

Javier Vaquero, MD, PhD
Hospital General Universitario Gregorio Maranon, Spain


Abstract

Background

Although the results of hip arthrodesis compare favorably with those of total hip arthroplasty (THA) in younger patients, long-term consequences such as osteoarthritis of the neighboring joints may necessitate conversion of the arthrodesis to THA.

Questions/Purposes

The purpose of the present study is to assess mid-term clinical outcome and self-perceived improvement in patients who underwent conversion at our department. Secondary aims were incidence of complications and association between patient characteristics and characteristics of the fusions with the outcome of the procedure.

Patients and Methods

The study sample comprised 21 cases in 20 patients. Minimum follow-up was 3 years (mean, 8 ± 6.5 years) in 20 cases. Thirteen patients had surgical hip fusions and 7 (8 hips) had nonsurgical fusions. Mean age at the time of conversion was 58.5 years.

Results

Nineteen out of 21 cases had functioning implants at the latest follow-up visit. According to the Merle d’Aubigné scale, outcome was considered excellent, very good, or good in 15 cases. Lower back pain was reduced in all patients. All but two patients were satisfied after the conversion. The main complications observed included incomplete removal of bone block, intra-operative fractures, dislocation and damage to the femoral artery. Time to conversion and type of fusion had no significant correlation with the clinical outcome.

Conclusions

Conversion THA is a challenging but successful procedure according to the mid-term clinical outcome observed. Our study suggests that, prognostic factors should be used with caution when establishing indications and post-surgical expectations.

This article appears in HSS Journal: Volume 9, Number 2.
View the full article at springerlink.com.

About the HSS Journal

HSS Journal, an academic peer-reviewed journal published three times a year, February, July and October. The Journal accepts and publishes peer reviewed articles from around the world that contribute to the advancement of the knowledge of musculoskeletal diseases and disorders.


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