The long-term fate of the hip arthrodesis: does it remain a valid procedure for selected cases in the 21st century?
Even in current orthopaedic practice, some cases are still not suitable candidates for hip replacement and hip fusion remains the only option in these highly selected patients. In this retrospective study we describe the long-term clinical outcome, quality of life and radiological evaluation of all adjacent joints in a cohort of 47 hip fusions. The main objective of our study was to show the long-term effects of a fusion. Thirty patients were analysed after an average of 18.2 years (range 6.2-30.5 years) with a mean SMFA of 31.2 (range 9-70). The VAS for pain for the fused hip was an average 1.9 (range 0-8), for the contralateral hip 2.0 (0-8), for the ipsilateral knee 2.0 (0-8), for the contralateral knee 1.8 (0-8) and for the lower back 3.6 (0-8). Average walking distance was 115 minutes (range 10-unlimited). Although the hip arthrodesis has lost popularity, it still is an option for the young patient with severe hip disorders, while leaving the possibility to perform a THA at a later stage. If the arthrodesis is performed with an optimal alignment of the leg, complaints from the adjacent joints are minimal, even in the long-term, and an acceptable quality of life can be obtained. We believe that in highly selected cases a hip fusion, even in current practice, is still a valid option.
Schafroth
Matthias U
MU
Department of Orthopedic Surgery, AMC, Amsterdam, The Netherlands.
Blokzijl
Reinoud J
RJ
Haverkamp
Daniël
D
Maas
Mario
M
Marti
René K
RK
D000293:Adolescent; D000328:Adult; D001170:Arthritis, Infectious / Q000601:surgery; D001174:Arthrodesis / Q000009:adverse effects* / Q000379:methods; D002648:Child; D004185:Disability Evaluation; D005260:Female; D005500:Follow-Up Studies; D006618:Hip Dislocation, Congenital / Q000601:surgery; D006621:Hip Joint / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength; D017060:Patient Satisfaction; D052097:Quadriceps Muscle; D011788:Quality of Life; D016059:Range of Motion, Articular; D055815:Young Adult
Clin Orthop Relat Res. 2004 Jan;(418):126-33
15043103
J Bone Joint Surg Am. 1975 Sep;57(6):759-65
1158910
J Bone Joint Surg Am. 1985 Dec;67(9):1328-35
4077903
J Arthroplasty. 1990 Mar;5(1):89-96
2319254
J Bone Joint Surg Am. 2002 Aug;84(8):1335-41
12177262
Ann Rheum Dis. 1957 Dec;16(4):494-502
13498604
J Bone Joint Surg Am. 1984 Jul;66(6):853-9
6234319
Int Orthop. 1983;7(3):159-64
6671851
Clin Orthop Relat Res. 1969 Jan-Feb;62:136-50
5774824
Int Orthop. 1989;13(2):129-33
2744915
Acta Orthop Scand. 1973;44(4):485-95
4771281
J Bone Joint Surg Am. 2000 Apr;82(4):561-9
10761946
Reconstr Surg Traumatol. 1974;14(0):1-37
4276309
J Bone Joint Surg Am. 1999 Sep;81(9):1245-60
10505521
J Am Acad Orthop Surg. 2002 Jul-Aug;10(4):249-58
15089074
Acta Radiol Diagn (Stockh). 1968;:Suppl 277:7-72
5706059
Can J Surg. 1995 Feb;38 Suppl 1:S39-45
7874627
Instr Course Lect. 2001;50:297-305
11372328
J Bone Joint Surg Am. 1950 Jan;32A(1):48-58
15409257
Orthopade. 1996 Apr;25(2):129-39
8692566