Hip arthroplasty after previous arthrodesis.
Total hip arthroplasty after previous arthrodesis has been associated with increased complications and decreased survivorship of the prosthesis. We evaluated pain, function, and the factors influencing survivorship of total hip arthroplasties after previous arthrodesis between 1985 and 2000 and compared these results with those obtained in prior years with the same procedure and in the same institution. We retrospectively reviewed 30 patients who had previous spontaneous or surgical arthrodesis. The minimum followup was 2 years (mean, 10.4 years; range 2-20.5 years). Seven failures were identified (23%). The overall survival free of failure was 86% at 5 years and 75% at 10 years. At last followup, 27 of the 30 patients (91%) had no or slight pain, 26 (87%) had a limp, and 18 (61%) needed a gait aid. Surgical arthrodesis, age younger than 50 years at the time of arthroplasty, and length of arthrodesis less than 30 years independently predicted failure. Conversion of arthrodesis to hip arthroplasty reliably decreases pain and improves function, but many patients will limp and require a gait aid. Our outcomes were similar to those after revision rather than after primary hip arthroplasty.


METHODS
Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
Peterson
Erik D
ED
Orthopaedic Consultants, Sioux Falls, SD, USA.
Nemanich
Joseph P
JP
Altenburg
Aaron
A
Cabanela
Miguel E
ME
D000328:Adult; D000367:Age Factors; D000368:Aged; D001168:Arthritis / Q000473:pathology / Q000601:surgery*; D001174:Arthrodesis / Q000009:adverse effects* / Q000379:methods; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects / Q000379:methods*; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006621:Hip Joint / Q000503:physiopathology / Q000601:surgery*; D006622:Hip Prosthesis; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015207:Osteoarthritis, Hip / Q000473:pathology / Q000601:surgery; D011183:Postoperative Complications / Q000175:diagnosis / Q000601:surgery; D011475:Prosthesis Failure; D012086:Reoperation / Q000379:methods; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D012737:Sex Factors; D018709:Statistics, Nonparametric; D013997:Time Factors; D016896:Treatment Outcome
J Bone Joint Surg Am. 1985 Dec;67(9):1328-35
4077903
J Bone Joint Surg Am. 1984 Apr;66(4):540-6
6707032
J Bone Joint Surg Am. 2002 Aug;84(8):1335-41
12177262
J Bone Joint Surg Am. 2001 Jul;83(7):992-8
11451967
Clin Orthop Relat Res. 1990 Aug;(257):107-28
2199114
Orthopade. 2004 Aug;33(8):939-56; quiz 957
15257433
J Bone Joint Surg Am. 1988 Aug;70(7):963-6
3403586
J Bone Joint Surg Am. 1975 Jan;57(1):27-30
123532
Chir Organi Mov. 1994 Jul-Sep;79(3):251-63
7842836
J Bone Joint Surg Am. 1975 Jul;57(5):619-25
1150702
J Bone Joint Surg Br. 2004 Aug;86(6):801-8
15330018
Acta Chir Orthop Traumatol Cech. 2004;71(2):101-5
15151097
J Bone Joint Surg Am. 1990 Jan;72(1):45-54
2295672
J Rheumatol. 2007 Feb;34(2):394-400
17143967
Clin Orthop Relat Res. 1985 Mar;(193):133-40
3971612
Z Orthop Ihre Grenzgeb. 2000 Jul-Aug;138(4):318-23
11033899
J Bone Joint Surg Br. 2007 Nov;89(11):1446-51
17998179