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Related Experiment Videos

Joint replacement for ankylosed hips.

D J Kilgus1, H C Amstutz, M A Wolgin

  • 1Division of Orthopaedic Surgery, University of California, Los Angeles.

The Journal of Bone and Joint Surgery. American Volume
|January 1, 1990
PubMed
Summary
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Total hip replacement effectively converted fused hips, improving pain and mobility. Outcomes were comparable to primary hip arthroplasty in select patients, with a 96% implant survival rate at 13 years.

Area of Science:

  • Orthopedic Surgery
  • Reconstructive Surgery

Background:

  • Fused hips (ankylosis) can cause significant pain, functional limitation, and secondary issues like knee instability.
  • Conversion total hip replacement (THR) is a complex procedure for managing ankylosed hips.

Observation:

  • Forty-one fused hips in 38 patients underwent conversion THA with a mean 7-year follow-up.
  • Indications included disabling pain, immobility, malposition, and knee problems.
  • Postoperative improvements included an 87-degree flexion arc and 2.5 cm limb length equalization.

Findings:

  • Significant pain relief, improved hip mobility, and reduced walking aid dependence were observed.
  • Abductor muscle function recovery depended on preoperative quality and biomechanical restoration.
  • Nine failures (sepsis, component loosening/malposition) occurred, primarily in younger, multiply operated, or previously injured hips.

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  • Implant survival probability was 96% at 13 years.

    • Implications:

    • Conversion THA offers a viable solution for fused hips, yielding results comparable to primary THA in select patient groups.
    • Careful patient selection, particularly regarding age and prior surgical history, is crucial for optimal outcomes.
    • Long-term implant survival is promising, suggesting the durability of this reconstructive approach.