Hip arthrodesis in young patients. A long-term follow-up study.

Artrodese do quadril: estudo retrospectivo com mais de 20 anos de seguimento

“…Initially, most surgeons that performed arthrodesis sought a slight degree of abduction that was later related to the greater association with presence of low back and homolateral knee pain. 14,15 Yet in our study, of the ten patients that presented excessive abduction, only three reported low back pain. However, of the four patients that evolved with knee osteoarthritis, three presented excessive hip abduction, which suggests the same association described by these authors.…”

“…However, of the four patients that evolved with knee osteoarthritis, three presented excessive hip abduction, which suggests the same association described by these authors. 14,15 Conversion surgery of hip arthrodesis into total replacement normally produces a significant improvement in low back pain and restoration of local mobility, yet in addition to the technical difficulty inherent to this surgery, remember that on the long term, the results are inferior to those habitually encountered in patients with hip osteoarthritis, with acetabular laxity between 15 and 20% after 10 years. [17][18][19] Among the female patients, the difficulty in hip mobilization with negative repercussion on the conjugal relationship is a fact to be considered and was reported by the four patients that had desarthrodesis indication in our study.…”

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

“…Between 10% and 21% [12,63,64,70] of patients with fused hips eventually request conversion to a THA, unwilling to accept the functional effects of ankylosis in daily living and the associated symptoms attributable to progressive deterioration of the neighboring joints. However, some authors believe that function, range of mobility, muscle strength, persistence of limp, and need for assistive walking aids are less satisfactory after conversion of a fused hip to a THA compared with a conventional PTHA [40,52,53,55,57,62,69], with a rate of major complications ranging from 15% to 54% [40,53,55,57,62,65,73,74].…”

“…Functional impairment, and pain and degeneration of the neighboring joints are frequent problems associated with a long-term fused hip [12,52,63,64,68,70]. Between 35% Each author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.…”

“…and 60% of patients with fused hips complain of knee pain and between 57% and 65% complain of low back pain [12,68,70]. Many surgeons consider disability resulting from a fused hip, pain in the surrounding joints, malpositioned ankylosis, or painful pseudarthrosis as indications to convert a fused hip to a THA [12, 45, 52, 62-65, 68-70, 72, 74, 77, 78].…”