gms | German Medical Science

Deutscher Kongress für Orthopädie und Unfallchirurgie (DKOU 2017)

24.10. - 27.10.2017, Berlin

Total hip arthroplasty for fused hip

Meeting Abstract

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  • presenting/speaker Afshin Taheriazam - Tehran Medical Sciences Branch, Islamic Azad University, Tehran, Iran, Islamic Republic of
  • Farshad Safdari - Bone, Joint and related tissues research center, Shahid Beheshti University of medical sciences, Tehran, Iran, Islamic Republic of

Deutscher Kongress für Orthopädie und Unfallchirurgie (DKOU 2017). Berlin, 24.-27.10.2017. Düsseldorf: German Medical Science GMS Publishing House; 2017. DocIN33-1212

doi: 10.3205/17dkou081, urn:nbn:de:0183-17dkou0818

Veröffentlicht: 23. Oktober 2017

© 2017 Taheriazam et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.


Gliederung

Text

Objectives: Previously, hip arthrodesis was performed for some patients with end-stage hip disease. Although these patients experienced considerable pain relief and functional improvement, however, long-term fused hip can be associated with several problems such as severe low back pain, ipsilateral knee pain and degeneration. Conversion of a hip arthrodesis to total hip arthroplasty is a rare and challenging procedure. Some authors have found that this surgery is associated with increased complications and decreased survivorship of the implant. In current study, we prospectively investigated the short-term results of THA in previously fused hips.

Methods: Between 2009 and 2012, we operated on 25 patients with previously hip arthrodesis. The age of the patients at the time of arthrodesis averaged 27.1 years and at the time of THA 51.3 years. Of them, 9 patients were female. The underlying diagnosis for arthrodesis were septic arthritis in 6 patients, post-traumatic arthritis in 9 patients, developmental dysplasia in 3 patients, failed THA in 4 patients and slipped capital femoral epiphysis in 3 patients. The chief complaint was sever LBP in 8 patients, severe ipsilateral knee pain in 11 patients and both in 6 patients. Furthermore, all of the patients asked for more functional improvement and free hip range of motions. All of the surgeries were performed by the same surgeon (A.T). The patients underwent the same rehabilitation protocol after the operation and followed for 2 years.

Results and Conclusion: At the last visit, 21 patients were pain free or suffered from mild pain (84%). In these patients the pain intensity decreased from 7.1±2.1 to 1.3±0.9 based on visual analogue scale (VAS). These patients were able to independently ambulate and perform activities of daily living. Harris hip score improved from 69.6±15.4 to 83.7±6.5. Also, Oxford hip score decreased from 32.3±8.7 to 19.6±6.1. Two of the remaining patients had severe pain after the operation and two others needed assistive devices for ambulation. Heterotrophic ossification occurred in 2 patients but did not disturbed the joint ROM. Paresia of the common fibular nerve occurred in 3 patients which resolved after 3 months in all of them. Limping was found in 3 patients at the last visit. There was no case of nonunion, loosening, dislocation and infection.

THA in patients with fused hip can effectively relieve the pain and improve the function. The procedure is technically demanding and patients should be aware of high risk of complications. Also, the procedure may be not helpful in some patients as they expect.