Total hip arthroplasty for arthrodesed hips

Is Total Hip Arthroplasty after Hip Arthrodesis as Good as Primary Arthroplasty?

“…The HHSs achieved by our patients after conversion were similar to those reported in other studies [53,58,62] and, although lower than those for the PTHA for the general population [37,42], they were comparable or better than those obtained in other particular populations such as young patients, patients with high demands, or patients with an important handicap secondary to multivariate hip disorders or polyarticular impairment [43,56]. The change in HHS after THA was greater in our series than in other studies [54,55]. We further observed a change in QOL from before THA to after THA.…”

“…The different levels of patient satisfaction substantially reflect the changes in the mentioned scores [17,20]. The satisfaction rate and level of satisfaction with conversion were similar between our study cohort and reported rates [36,45,55,57], and with reported rates after PTHA [9,20,24,47,76]. Patient satisfaction depends on a mixture of different factors and patient expectations [16,21,43,47], and patients in a worse preoperative condition tend to be more satisfied after THA than those in better condition [17,20,21,47].…”

“…However, some authors believe that function, range of mobility, muscle strength, persistence of limp, and need for assistive walking aids are less satisfactory after conversion of a fused hip to a THA compared with a conventional PTHA [40,52,53,55,57,62,69], with a rate of major complications ranging from 15% to 54% [40,53,55,57,62,65,73,74]. However, some consider it a satisfactory procedure [30,36,54,62], achieving similar improvement of symptoms, success rate, patient satisfaction, and survivorship as a PTHA [4,40,49].…”

“…Regarding pain and function in the surgically treated hip, 79% to 85% of hips are painfree or with minimal pain [36,45,64], 79% have ''good-toexcellent'' ROM [36], and 83% have ''good-to-excellent'' function [36], obtaining an average postoperative hip flexion between 708 and 1028 [29,40,45,49,54,65] and improvement in walking [29]. Overall function and walking improves after conversion [54,55,58]. Survival of the converted THA ranges from 74% to 96% at 10 years [29,36,53,57] and 73% at 26 years [36].…”

“…Survival of the converted THA ranges from 74% to 96% at 10 years [29,36,53,57] and 73% at 26 years [36]. Between 75% and 100% of patients are satisfied with the procedure [29,36,40,45,49,55,57,62,65,73], and they generally are pleased with the outcome even if factors such as range of mobility, muscle strength, LLD, persistence of limp, and need of assistive walking aids are less satisfactory in converted hips compared with hips that had conventional primary THA [40,52,55,69]. A patient's satisfaction with the obtained outcome may be related more to the global change achieved in QOL than to 'objective' data assessed by the surgeon.…”