Total hip arthroplasty following arthrodesis: a single-center experience of 17 patients

Abstract

Purpose: We aimed to present our experience with total hip arthroplasty in patients with previous hip arthrodesis. Patients and methods: This was a retrospective study, in which clinical and radiological outcomes of total hip arthroplasty performed in 17 patients (mean age 54.2 +/- 8.5 years; age range 33-68 years; female to male ratio 10/7) with previous arthrodesis in our clinic between 2001 and 2014 were reviewed. Patients were followed up for 6.7 +/- 2.8 years (range 3-12 years) after the operation and evaluated for ipsilateral knee pain, range of motion, walking capacity, and leg-length discrepancy. The clinical outcome was assessed by the Harris Hip Score. Results: The outcome of arthroplasty was good or excellent in 14 of 17 patients (82.3%), fair in two patients (11.8%), and failure in one patient (5.9%). The Harris Hip Score increased to 79.8 +/- 9.8 postoperatively from a preoperative score of 40.9 +/- 10.1 (p<0.01). Pain-free hip was obtained in 15 patients (88.2%), and range of motion was 88 degrees. Fourteen patients (82.4%) reported a significant decrease in back pain, and 11 patients (64.7%) in ipsilateral knee pain. Ten patients (58.8%) were able to walk normally, five patients (29.4%) walked with slight Trendelenburg gait without support, and two patients (11.8%) with severe Trendelenburg gait using arm rests. The mean leg-length discrepancy was 1.1 cm (range 0-3 cm). The complications were peroneal nerve palsy (n=3), superficial wound infection (n=3), hip dislocation (n=2), and heterotopic ossification (n=3). Conclusion: If it is well planned, conversion of hip arthrodesis to total hip arthroplasty is a successful and safe procedure, which increases patients' functionality.