Results of Conversion from Failed Austin-Moore Hemiarthroplasty to Cementless Total Hip Arthroplasty in Octogenarian Patients with Advanced Acetabular Erosion: A Minimum of 5 Years of Follow-Up

Abstract

Austin-Moore hemiarthroplasty (HA) had been selectively used for elderly patients with femoral neck fractures. With increasing life span and activity, the sequela of Austin-Moore HA make the implant no longer favorable. The treatment of failed Austin-Moore HA with advanced acetabular erosion is challenging; however, little has been published regarding this topic. The aim of this study was to evaluate the mid-term results of using cementless total hip arthroplasty (THA) in octogenarians. Between 2008 and 2011, 47 patients (32 women and 15 men) with an average age of 86 years (range 83-89 years) were enrolled in this retrospective study. After an average follow-up period of 6.2 years (range 5.0-7.8 years), no migration or loosening of the cup or femoral stem was found. Harris hip scores improved from 36 (range 15-42) preoperatively to 87 (range 80-90). There were no complications directly associated with the procedure except for superficial infections in two patients. Our results suggest that using cementless THA can result in favorable radiographic and clinical outcomes in octogenarian patients.

The short-term outcomes of cementless stem for hip arthroplasty in the elderly patients: comparison with patients < 65 years

“…There were no significant increases in incidence rate of periprosthetic fractures, infections, and deep vein thrombosis compared with younger patients. This study is similar to the results of Huang et al [ 7 ] and Koettnitz et al [ 15 ], and provides valuable imaging evidence on this basis.…”

“…Koettnitz et al [15] proved that, compared with patients < 60 years, cementless femoral prosthesis implantation in a patient more than 80 years is a safe procedure with no increased risk of surgery-related complications. Huang et al [7] also showed that the use of cementless THA can bring good clinical results for patients older than 80 years, but the deficiency is that fewer patients are included, and the evaluation results are only Harris score and postoperative complications, without imaging measurement results. But some scholars put forward the opposite view.…”

“…For young patients and patients with high mobility requirements, long-term follow-up shows that cementless prosthesis can achieve higher hip score [ 6 ]. However, recent study believe that hip replacement with cementless prosthesis can also achieve good imaging and clinical results in elderly patients [ 7 ].…”

Conversion of failed hip hemiarthroplasty to Total hip replacement

“…These issues may include acetabular erosion, protrusion, or malpositioning, as well as femoral stem migration or component loosening. When a hemiarthroplasty procedure fails in this manner, the revision or conversion to a total hip replacement (THR) becomes a necessary and complex surgical intervention [3] .…”

Probabilistic analysis of Improved Austin-Moore stem used in cementless total hip arthroplasty considering loading uncertainty

“…The high complication rates following osteoporotic femoral neck fractures can leads to destructive effects on the patient and increase the burden on health care systems. The number of the total hip replacement number is increasing accordingly (Huang et al 2016;Huang et al 2019). Austin-Moore prostheses had been selectively utilized for the total hip arthroplasty.…”