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Hip arthroplasty after previous arthrodesis.

Erik D Peterson¹, Joseph P Nemanich, Aaron Altenburg

¹Orthopaedic Consultants, Sioux Falls, SD, USA.

Clinical Orthopaedics and Related Research

|August 20, 2009

Summary

Total hip arthroplasty following hip fusion reliably reduces pain and improves function. However, many patients experience a limp and require walking aids, with surgical fusion and younger age predicting poorer outcomes.

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Area of Science:

Orthopedic Surgery
Arthroplasty
Hip Reconstruction

Background:

Total hip arthroplasty (THA) after previous hip arthrodesis presents unique challenges.
Outcomes and survivorship can be compromised compared to primary THA.

Purpose of the Study:

To evaluate pain, function, and survivorship of THA following prior arthrodesis.
To identify factors influencing THA outcomes in this patient cohort.

Main Methods:

Retrospective review of 30 patients undergoing THA after hip arthrodesis (1985-2000).
Minimum 2-year follow-up (mean 10.4 years).
Comparison with historical data from the same institution.

Main Results:

Overall failure rate was 23% (7/30 patients).

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Survival free of failure was 86% at 5 years and 75% at 10 years.

Significant improvements in pain (91% no/slight pain) and function, though 87% had a limp and 61% needed a gait aid.

Conclusions:

THA after arthrodesis effectively alleviates pain and improves function.
Surgical arthrodesis, younger age (<50), and shorter arthrodesis duration (<30 years) independently predicted failure.
Outcomes were comparable to revision THA, highlighting the complexity of this procedure.