Differences in Post-Operative Outcome Between Conversion and Primary Total Hip Arthroplasty

Qin, Charles; Helfrich, Mia M.; Fitz, David W.; Oyer, Mark A.; Hardt, Kevin D.; Manning, David W.

doi:10.1016/j.arth.2017.11.039

Cited by 26 publications

(22 citation statements)

References 27 publications

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“…Due to its retrospective nature confounding factors such as patient expectations were not investigated. McLawhorn et al and Qun et al found that patients who underwent cTHA required more transfusions, had longer operative times and length of hospital stays, and more often had non-home bound discharge [ 13 , 15 ]. Due to the absence of these data, no cost analysis could be made.…”

Section: Discussionmentioning

confidence: 99%

“…Interpreting these studies is difficult, as matched cohort analyses are rare, follow-up differs between groups, but most importantly because of the fact that very diverse groups of cTHA’s are compared to very diverse groups of rTHA’s [ 10 – 17 ]. This raises the question whether it is useful to predict outcomes based on this distinction in the first place [ 15 , 16 ]. There is a subgroup of patients who undergo cTHA using primary implants, who will never develop any complications and whose satisfaction probably resemblances those of patient with pTHA’s [ 17 ].…”

Section: Introductionmentioning

confidence: 99%

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RETRACTED ARTICLE: The majority of conversion total hip arthroplasties can be considered a primary replacement: a matched cohort study

et al. 2020

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Background and study aims The success of conversion total hip arthroplasty (THA) among primary THA and revision THA remains unclear. We hypothesized that most conversion THA’s can be performed using primary implants and will have an uncomplicated post-operative course. Materials and methods Thirty-six patients (23 females, mean age 68,0y) who underwent conversion THA for failed interventions for proximal femur fractures in the period 2008–2018 were matched sequentially against patients of the same sex and age who underwent primary THA or revision THA. Data were collected on implants used, major complications, and mortality. PROMs used included the Western Ontario and McMaster Osteoarthritis Index, Harris Hip Score, Visual Analogue Scale and the EQ-5D Health Questionnaire. Results Seventy-two percent of patients who underwent conversion THA were treated with primary implants and never suffered from a major complication. PROMs were excellent for this group of patients. The distinction primary/conversion/revision THA could not explain differences in outcomes; however, the necessity of using revision implants and the development of major complications could. Conclusions The majority of conversion total hip arthroplasties can be considered a primary replacement. Predicting outcomes for THA should focus on patient frailty and technical difficulties dealing with infection, stability and loss of bone stock and should discard the conversion versus revision terminology.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

RETRACTED ARTICLE: The majority of conversion total hip arthroplasties can be considered a primary replacement: a matched cohort study

et al. 2020

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“…THA for hip fractures and conversion THA in the Medicare-covered population were both found to be associated with an increased risk of CMS-reportable complications, nonhomebound discharge, and readmission [38][39][40][41] . A recent study from Duke University Hospital showed an approximate 19% greater cost for conversion THA compared with primary THA 42 .…”

Section: Prior Hip Pathologymentioning

confidence: 99%

What’s New in Hip Replacement

Glassman

2018

The Journal of Bone and Joint Surgery

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“…11 Reports of CTHA following prior failed IT or DHS fixation are insufficient and commonly consist of small samples. 4,11,12 Additionally, the clinical outcomes of most studies have been affected by either the prosthetic design or bearing materials. 1,6,7,13 The objective outcomes and factors influencing these outcomes are difficult to appreciate without large, comprehensive series.…”

Section: Introductionmentioning

confidence: 99%

“…The performance of hip arthroplasty procedures after the development of intertrochanteric hip fractures (IHFs) has become increasingly more common during the past two decades, with primary procedures increasing by >130% and revision procedures increasing by >10%. [1][2][3] In the recently published literature, 4,5 the need for conversion total hip arthroplasty (CTHA) following prior failed InterTan nail (IT) fixation or dynamic hip screw (DHS) fixation has increased and is expected to further increase given the expanded indications for primary procedures coupled with a progressively more active population. Furthermore, secondary hip dysfunction resulting in instability or decreased function after failed IT or DHS fixation frequently necessitates CTHA.…”

Section: Introductionmentioning

confidence: 99%

Poor outcomes for osteoporotic patients undergoing conversion total hip arthroplasty following prior failed dynamic hip screw fixation: a nationwide retrospective cohort study

Lai

Zhang

et al. 2019

J Int Med Res

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Objectives This study was performed to compare the long-term clinical and radiological outcomes of conversion total hip arthroplasty (CTHA) following prior failed InterTan nail (IT) fixation or dynamic hip screw (DHS) fixation in Asian patients with osteoporotic intertrochanteric hip fractures (IHFs) and to clarify which implant tends to be more favourable for CTHA. Methods Records of consecutive Asian patients with osteoporosis who underwent conversion of failed primary unilateral IT or DHS fixation to THA from 2010 to 2013 were extracted from the comprehensive database of the China Pacific Insurance Company Ltd. All consecutive procedures were managed by high-volume surgeons. The primary endpoint was the clinical outcome. The secondary endpoint was the radiological outcome. Results In total, 447 Asian patients with osteoporotic IHFs (DHS, n = 223; IT, n = 224) were assessed during a median follow-up of 46 months (range, 39–53 months). The two groups showed a significant difference in the Harris hip score at final follow-up and in the orthopaedic complication rate (DHS, 20.2%; IT, 9.8%). Conclusion Conversion to THA following prior failed DHS fixation tends to be associated with poorer clinical and radiological outcomes in Asian patients with osteoporotic IHFs than that following prior failed IT fixation.

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Differences in Post-Operative Outcome Between Conversion and Primary Total Hip Arthroplasty

Cited by 26 publications

References 27 publications

RETRACTED ARTICLE: The majority of conversion total hip arthroplasties can be considered a primary replacement: a matched cohort study

RETRACTED ARTICLE: The majority of conversion total hip arthroplasties can be considered a primary replacement: a matched cohort study

What’s New in Hip Replacement

Poor outcomes for osteoporotic patients undergoing conversion total hip arthroplasty following prior failed dynamic hip screw fixation: a nationwide retrospective cohort study

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