High Rate of Complications With Early Conversion Hip Arthroplasty Following Fracture Treatment
Whisper Grayson1, Carlo Eikani, Meredith Benson
1From the Department of Orthopaedic Surgery and Rehabilitation Loyola University Health System, Maywood, IL (Dr. Grayson, Dr. Eikani, and Dr. Brown); and the Loyola University Chicago Stritch School of Medicine, Maywood, IL (Ms. Benson and Mr. Jozefowski).
Insights
Early conversion total hip arthroplasty (THA) after hip fracture fixation is linked to significantly higher complication rates, including infection and revision surgery. Patients should be informed about these increased risks before undergoing early THA conversion.
Area of Science:
- Orthopedic Surgery
- Arthroplasty
- Trauma Surgery
Background:
- Conversion total hip arthroplasty (THA) carries higher complication risks than primary THA.
- Prior hip fracture fixation further elevates complication rates in conversion THA.
- Limited data exists on the impact of conversion THA timing on complication rates.
Purpose of the Study:
- To evaluate the effect of early (≤6 months) versus late (>6 months) conversion THA on complication rates.
- To compare complication profiles between early and late conversion THA following proximal femur or acetabulum fracture fixation.
Main Methods:
- Retrospective review of 91 patients undergoing conversion THA after hip fracture fixation.
- Data collected on index surgery, fracture characteristics, timing of conversion, and failure cause.
- Postoperative complications assessed: infection, revision surgery, dislocation, and revision THA rates.
Main Results:
- Early conversion THA (n=22) showed higher complication rates (22.7%) compared to late conversion (n=69, 11.6%).
- Deep infection (18.2% vs. 5.8%) and revision surgery (22.7% vs. 10.1%) were more frequent in the early group.
- The early conversion group experienced significantly higher rates of perioperative blood transfusion (P=0.013).
Conclusions:
- Early conversion THA following failed hip fracture fixation is associated with a high complication rate.
- Patients considering early conversion THA should be counseled regarding elevated risks.
- Timing of conversion THA is a critical factor influencing patient outcomes.
Background:
Conversion total hip arthroplasty (THA) is associated with higher rates of complications compared with primary THA, with prior surgical fixation of fractures in the ipsilateral hip shown to further increase these rates. There is a scarcity of literature on the effect of timing of conversion THA on complication rates. In this study, we evaluated early (≤6 months of index surgery) and late (>6 months of index surgery) conversion to THA following prior fixation of the proximal femur or acetabulum.
Methods:
Ninety-one patients who underwent conversion THA following prior surgical fixation of either the proximal femur or acetabulum were identified. Index surgery, fracture characteristics, time, and cause of failure were obtained. Postoperative complications evaluated following the conversion THA included infection, revision surgery rates, dislocation, and revision rates.
Results:
A total of 91 patients were included, of which 22 underwent early conversion to THA. In the early conversion group, 22.7% of patients had a complication versus 11.6% of patients in the late conversion group (P = 0.194). The most common complications were deep infection (18.2% vs. 5.8%), revision surgery (22.7% vs. 10.1%), and revision THA (18.2% vs. 5.8%). The early conversion group had a markedly higher rate of perioperative blood transfusion compared with the late cohort (P = 0.013).
Conclusion:
In this study, we found a high rate of complications associated with early THA conversion. Patients should be counseled on the high risk for complications following early conversion to THA following failed fracture fixation.
