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Total hip arthroplasty after excision arthroplasty: indications and limits
Dante Dallari1, Milena Fini, Chiara Carubbi
1Orthopaedic and Traumatology Department I, Rizzoli Orthopaedic Institute and University of Bologna, Bologna - Italy.
Summary
Revision total hip arthroplasty (THA) after hip excision arthroplasty for sepsis significantly improved limb length discrepancy and walking ability. Younger patients (<65) experienced greater range of motion improvements. Careful patient selection is crucial for successful outcomes.
Area of Science:
- Orthopedic Surgery
- Reconstructive Surgery
- Arthroplasty
Background:
- Excision arthroplasty is a salvage procedure for hip sepsis.
- Revision to total hip arthroplasty (THA) presents unique challenges.
- Outcomes of THA following prior excision arthroplasty are not well-defined.
Purpose of the Study:
- To evaluate the outcomes of total hip arthroplasty (THA) revision in patients previously treated with excision arthroplasty for sepsis.
- To assess functional improvements and complications in this patient cohort.
Main Methods:
- Retrospective review of 16 patients who underwent revision THA after excision arthroplasty for sepsis.
- Mean follow-up duration of 96 +/- 15 months.
- Assessment of limb length discrepancy, walking capability, and range of motion.
Main Results:
- Significant reduction in limb length discrepancy was observed.
- Marked improvement in walking capability was noted post-revision THA.
- Range of motion improvements were most pronounced in patients under 65 years of age.
Conclusions:
- Revision total hip arthroplasty (THA) can yield positive functional results after hip sepsis treated with excision arthroplasty.
- Patient selection is critical due to the complexity of these cases.
- Outcomes may be less satisfactory compared to primary THA, necessitating careful consideration.