Hip arthrodesis converted to THA associated with high complication rates

Posted in: Healio.com | Posted on: 06 August, 2018

Researchers at the University of Leeds, in Leeds, United Kingdom, found complication rates were high after arthrodesis in eight studies and after conversion from hip arthrodesis to total hip arthroplasty in eleven studies, according to results of a systematic review.“Arthrodesis of the hip provides excellent rates of union allowing most patients to live a pain-free life for many years,” Sameer Jain, MB, ChB, MRCS, and colleagues wrote in the study. “However, altered hip biomechanics ultimately lead to adjacent joint pain with many suffering from lower back and knee pain. Many of these patients will therefore require conversion [total hip arthroplasty] THA to restore hip function and relieve pain.”Jain and colleagues analyzed results of 249 hips in eight published studies and found union rates of 37.5% to 100%, patient satisfaction rates of 69% to 100% and an overall 8.4% complication rate. In those studies, adjacent joint pain was reported in the low back in up to 75% of cases and in the ipsilateral knee in up to 57% of cases, according to the abstract.In 11 studies that investigated conversion to THA, Jain and colleagues noted a 54% complication rate, which was due to factors such as mechanical failure, nerve palsy and deep infection.“Patients must be aware that although complete pain relief is unlikely, functional improvement can be expected. However, this is a technically challenging procedure with less satisfying results than primary THA,” Jain and colleagues wrote. “Complication and revision rates are high and for this reason, arthrodesis of the hip should be considered with caution in younger, more active patients with greater physical demands. However, with newer implant designs, bearing couples, fixation methods and advances such as computer-assisted surgery, success rates of conversion THA may improve.”