Hip and Knee Replacement After Longstanding Hip Arthrodesis

Rittmeister, M.; Starker, M.; Zichner, Ludwig

doi:10.1097/00003086-200002000-00017

Cited by 45 publications

(33 citation statements)

References 17 publications

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“…Our data confirm that of other studies [29,36,40,49,54,58,65] documenting improved function and QOL after conversion and similar to the improvements after a PTHA ( Table 5). The HHSs achieved by our patients after conversion were similar to those reported in other studies [53,58,62] and, although lower than those for the PTHA for the general population [37,42], they were comparable or better than those obtained in other particular populations such as young patients, patients with high demands, or patients with an important handicap secondary to multivariate hip disorders or polyarticular impairment [43,56]. The change in HHS after THA was greater in our series than in other studies [54,55].…”

Section: Discussionsupporting

confidence: 91%

“…Regarding pain and function in the surgically treated hip, 79% to 85% of hips are painfree or with minimal pain [36,45,64], 79% have ''good-toexcellent'' ROM [36], and 83% have ''good-to-excellent'' function [36], obtaining an average postoperative hip flexion between 708 and 1028 [29,40,45,49,54,65] and improvement in walking [29]. Overall function and walking improves after conversion [54,55,58]. Survival of the converted THA ranges from 74% to 96% at 10 years [29,36,53,57] and 73% at 26 years [36].…”

Section: Introductionmentioning

confidence: 99%

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Is Total Hip Arthroplasty after Hip Arthrodesis as Good as Primary Arthroplasty?

Fernández-Fairén

Murcia-Mazón

Torres

et al. 2011

Clinical Orthopaedics &Amp; Related Research

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Background Conversion of hip arthrodesis to a THA reportedly provides a reasonable solution, improving function, reducing back and knee pain, and slowing degeneration of neighboring joints associated with a hip fusion. Patients generally are satisfied with conversion despite the fact that range of mobility, muscle strength, leglength discrepancy (LLD), persistence of limp, and need for assistive walking aids generally are worse than those for conventional primary THA.

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Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

Is Total Hip Arthroplasty after Hip Arthrodesis as Good as Primary Arthroplasty?

Fernández-Fairén

Murcia-Mazón

Torres

et al. 2011

Clinical Orthopaedics &Amp; Related Research

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“…The options available to tackle this problem are to either convert a fused hip to a THA or carry out arthroplasties of other affected joints if the position and function of the fused hip are satisfactory. Although the latter option yielded unpredictable results in several reported series, it could still be the dominant option in a patient with a hip fused in a satisfactory position but with questionable abductor function 17–19…”

Section: Discussionmentioning

confidence: 99%

Hip arthrodesis in children: A review of 28 patients

et al. 2009

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Background:The best method of treating intractable hip pain in an unsalvageable hip joint in a child is still a subject open to debate. We believe that hip arthrodesis in such patients provides a painless and stable hip for most activities of daily living in our challenging rural terrain. Therefore, we conducted this study to assess the functional ability of children with painful hip arthrosis treated by arthrodesis of the hip.Materials and Methods:A retrospective evaluation of 28 children (out of 35) who had an arthrodesis of the hip performed between 1994 and 2008 was carried out. The average age was 14 years, with 12 males and 16 females. There was involvement of the right hip in 13 and left in 15 cases. The average duration of follow-up was 4.87 years. The preferred position of the hip for arthrodesis was 20–30° of flexion, neutral abduction-adduction, and neutral rotation, irrespective of the method of fixation.Results:The average duration of clinical and radiological arthrodesis was found to be 4 months (2–6 months). At the last follow-up, all patients were painfree and had good ambulatory capacity. The average Modified Harris Hip Score increased from 53 to 84 and the average post-surgical limb length discrepancy was 1.3 cm, which was well tolerated in all cases. Patients, however, had difficulty in squatting and had to modify their posture for foot care, putting on shoes, etc. Also, some patients complained of ipsilateral knee, contralateral hip, or low back pain with prolonged activity, but this was not severe enough to restrict activity except in one case that was known to have juvenile rheumatoid arthritis and needed ambulatory aid.Conclusion:In an environment where pathology generally presents very late and often in a dramatic manner, where the patient's socioeconomic status, understanding, compliance, and the logistics of follow-up are consistently a challenge in management, hip arthrodesis has been an important procedure for our patient group, with good short-term results and promising midterm, and, hopefully, long-term prospects. In our series of patients, we have been successful in restoring painfree mobility.

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“…Firstly, a TKR beneath a hip arthrodesis will be under abnormal stress. 1,26,27 Secondly, tensioning of the muscles crossing both hip and knee joints is better addressed by treating the hip first. 25 Thirdly, rehabilitation of the hip is possible with an ankylosed knee but it is very difficult to rehabilitate the knee with stiff hip, 25 and lastly, recovery from THR is usually less painful and demanding than after TKR.…”

Section: Discussionmentioning

confidence: 99%