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Total hip replacement after failed hemiarthroplasty
1Orthopaedic Hospital of the Invalid Foundation, Helsinki, Finland.
A retrospective follow-up study comprising 37 patients operated upon using total hip replacement (THR) following failed hemiarthroplasty (HA) is reported. The mean duration time after HA was 83 months. Twenty-four patients showed satisfactory results at a mean follow-up of 4.8 years, while 13 patients found the results unsatisfying from the very beginning. The mean (SD) observation time after THR was 50 (38) months. The mean (SD) age of 28 women and 9 men examined at the follow-up was 69 (10) years. The mean Mayo/Harris hip scores were 76/76 (range 41-98) points. The final results were excellent in nine, good in ten, fair in five and poor in thirteen cases. After complicated subcapital femoral fractures treated by HA, the final result after THR was excellent or good in four, fair in three and poor in seven cases. However, revision arthroplasty was performed in two cases, in the one because of loosening, in the other due to recurrent dislocation. Radiologically, at follow-up in 13 patients, 11 femoral and 6 acetabular components showed signs of loosening. In conclusion, THR can be recommended as primary operation for the treatment of acute subcapital femoral fractures in elderly and active patients.
A retrospective follow-up study comprising 37 patients operated upon using total hip replacement (THR) following failed hemiarthroplasty (HA) is reported. The mean duration time after HA was 83 months. Twenty-four patients showed satisfactory results at a mean follow-up of 4.8 years, while 13 patients found the results unsatisfying from the very beginning. The mean (SD) observation time after THR was 50 (38) months. The mean (SD) age of 28 women and 9 men examined at the follow-up was 69 (10) years. The mean Mayo/Harris hip scores were 76/76 (range 41-98) points. The final results were excellent in nine, good in ten, fair in five and poor in thirteen cases. After complicated subcapital femoral fractures treated by HA, the final result after THR was excellent or good in four, fair in three and poor in seven cases. However, revision arthroplasty was performed in two cases, in the one because of loosening, in the other due to recurrent dislocation. Radiologically, at follow-up in 13 patients, 11 femoral and 6 acetabular components showed signs of loosening. In conclusion, THR can be recommended as primary operation for the treatment of acute subcapital femoral fractures in elderly and active patients.