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

Abstract

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.

A Report on Three Consecutive Cases using Computer Tomography 3D Preoperative Planning for Conversion of Arthrodesed Hips to Total Hip Replacements

“…Moreover, all patients had effective pain relief in the neighboring joints. However, the range of motion was worse than that reported in other studies [4,7,8] and might be related to the routine adductors and iliopsoas tenotomies. Moreover, in one patient, intraoperative fracture of the acetabulum occurred when cutting the femoral neck.…”

Conversion of Arthrodesis to Total Hip Arthroplasty: Clinical Outcome, Complications, and Prognostic Factors of 21 Consecutive Cases

“…This may reflect a beneficial and continuous effect of THA on the abductor muscles and neighboring joints (spine, knee) after years or decades with an abnormal gait. Functional status was rated as poor or fair in 28.5% (6 out of 21) of our cases, which is clearly poorer than that of primary THA [4]. Spinal pain, as the main reason for conversion, may be associated with better results than knee pain or pain in the neighboring joints.…”

Long-term results of custom cementless-stem total hip arthroplasty performed in hip fusion

“…In our study, eight patients (12.5%) had a post-operative Trendelenburg sign, and strength of the abductor was graded as 5/5 or 4/5 in 21 patients (87.5%). In the study of Fernandez et al [5], none was graded as 5/5, and 30 patients were graded 4/5 (62%). This was significantly different compared with a primary THA control group, who presented better abductor muscle strength (5/5 in ten patients, 4/5 in 23).…”

“…Fused-hip conversion to total hip arthroplasty (THA) provides reasonable results, improving function and reducing pain [1][2][3]. However, the overall success and functional improvement following this procedure remain controversial compared with a conventional THA [2,[4][5][6]. The procedure remains technically demanding and is associated with a high complication rate [4,7,8].…”