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J. Clin. Med. 2019, 8(4), 503; https://doi.org/10.3390/jcm8040503

Conversion of Failed Hip Hemiarthroplasty to Low Friction Arthroplasty (LFA)

1
Orthopaedics, Sakarya University, Sakarya 54100, Turkey
2
Orthopaedics, Manchester University Hospitals, Manchester M23 9LT, UK
3
Orthopaedics, Wrightington Hospital, Wigan WN6 9EP, UK
*
Author to whom correspondence should be addressed.
Received: 13 March 2019 / Revised: 31 March 2019 / Accepted: 10 April 2019 / Published: 12 April 2019
(This article belongs to the Section Orthopedics)
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Abstract

Purpose: We aimed to study clinical and radiological outcomes of conversion from hemiarthroplasty to Charnley hip replacement (CHR) with a particular concern over reported increased dislocation rate and literature review. Conversion of hip hemiarthroplasty to total hip replacement (THR) is a procedure reported to have high rates of complications. In the literature, there is no specific study on small head conversion. The purpose of this study was to evaluate the conversion of failed hip hemiarthroplasty to CHR with the use of modern implants. Methods: The study included 42 patients, who underwent the above procedure. The operations were carried out using a modern Charnley-type THR with a 22-mm diameter of femoral head and a trans-trochanteric approach. The mean follow-up was 75.7 months (range 25–171). Radiographs from the last follow up were evaluated for loosening and other reasons of failure. Clinical outcome was assessed using postoperative pain, function scores, complications and implant survivorship as well as radiological evaluation. Charnley’s modified pain and mobility scoring system were used for clinical and Hodgkinson and Harris’ criteria were used for radiological assessment. Results: Functionally, all of the patients showed improvement. Mean improvement in the pain level was by average of 2.4. On mobility assessment, 38 patients (90.4%) improved. Three patients (7.1%) had recurrent infections and three (4.8%) cases were treated with revision surgery and pseudarthrosis. Further complications occurred in 19.1%, not requiring operative treatment. On radiological evaluation, one (2.4%) case showed cup demarcation without bone loss, two (4.8%) cup migration, and one (2.4%) stem demarcation. Kaplan Meier survival analysis showed a survival of 90% at 96 months of follow up (95% CI (confidence interval), 60–90). Conclusion: Larger head might not be the answer to decrease the dislocation rate. Complication rates during revision of hip hemiarthroplasty to modern CHR with 22.225-mm head diameter were comparable to first-time THR revision despite having a smaller head. View Full-Text
Keywords: low friction arthroplasty; conversion of hemiarthroplasty to THA (total hip arthroplasty); dislocation; failed hip hemiarthroplasty low friction arthroplasty; conversion of hemiarthroplasty to THA (total hip arthroplasty); dislocation; failed hip hemiarthroplasty
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Bayam, L.; Drampalos, E.; Nagai, H.; Kay, P. Conversion of Failed Hip Hemiarthroplasty to Low Friction Arthroplasty (LFA). J. Clin. Med. 2019, 8, 503.

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