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Conversion of Failed Hip Hemiarthroplasty to Low Friction Arthroplasty (LFA)

Levent Bayam1,2, Efstathios Drampalos3, Hajime Nagai4

  • 1Orthopaedics, Sakarya University, Sakarya 54100, Turkey. levbayam@hotmail.co.uk.

Journal of Clinical Medicine
|April 25, 2019
PubMed

Insights

Converting hip hemiarthroplasty to Charnley hip replacement (CHR) with a 22-mm head demonstrated comparable complication rates to first-time total hip replacement (THR) revisions. This study suggests smaller head sizes may not increase dislocation risks in these conversions.

Area of Science:

  • Orthopedic Surgery
  • Arthroplasty
  • Hip Replacement

Background:

  • Conversion of hip hemiarthroplasty to total hip replacement (THR) is associated with high complication rates.
  • Existing literature lacks specific data on the outcomes of small-head conversions.
  • Dislocation is a reported concern following hemiarthroplasty conversion.

Purpose of the Study:

  • To evaluate clinical and radiological outcomes of converting hemiarthroplasty to Charnley hip replacement (CHR) using modern implants.
  • To assess the dislocation rate and other complications in small-head hemiarthroplasty conversions.
  • To compare outcomes with existing literature on THR revisions.

Main Methods:

  • Retrospective study of 42 patients undergoing conversion to CHR with a 22-mm femoral head via a trans-trochanteric approach.
  • Mean follow-up of 75.7 months.
  • Clinical assessment using Charnley's modified pain and mobility scores; radiological assessment using Hodgkinson and Harris criteria.

Main Results:

  • Significant functional improvement observed in 90.4% of patients; mean pain reduction of 2.4 points.
  • Complications included recurrent infections (7.1%) and pseudarthrosis requiring revision (4.8%).
  • Radiological findings showed minimal issues: cup demarcation (2.4%), cup migration (4.8%), and stem demarcation (2.4%).
  • Kaplan-Meier survival analysis indicated 90% implant survival at 96 months.

Conclusions:

  • Conversion to modern CHR with a 22.225-mm head diameter yields complication rates comparable to first-time THR revisions.
  • Larger femoral head size may not be essential for reducing dislocation rates in these conversion procedures.
  • This approach offers a viable option for failed hip hemiarthroplasty with acceptable outcomes.

Keywords:
conversion of hemiarthroplasty to THA (total hip arthroplasty)dislocationfailed hip hemiarthroplastylow friction arthroplasty

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