Total Joint Replacement Following Failed Hemiarthroplasty

BackhroundsThere are some reports regarding the outcomes of conversion total hip arthroplasty (THA)following failure of hemiarthroplasty. However, it is necessary to perform more studies toassure the acceptable outcomes of previous studies. In current study, we continued ourprevious study on these patients with more number of patients and longer follow up periodMethodsA total of 138 patients from October 2009 till October 2014 had conversion of their failedhemiarthroplasties following a proximal femoral fracture to total hip arthroplasty (THA) inhospitals, . We performed a prospective analysis of the outcome of conversion surgery inpatients with failed hemiarthroplasty. The patients had clinical evaluations at 1 month, 6months, 1 year, and annually thereafter. We used Harris Hip Score (HHS) to evaluate theresults of conversion procedure in terms of relief of groin pain and functional improvement.ResultsDislocation occurred in 6 patients (%4.34). The mean period of follow-up was 42 months(range 60–36 months). HHS score improved from mean preoperative score of 8.40±44.93 to 2.27±95.41 at final follow-up. The survivorship analysis with revision of HHS score was%89.1. Existence of infection (P=.038) and time of primary operation to being symptomatic(P=.009) can predict the postoperative pain significantly.ConclusionsWe conclude that conversion of failed symptomatic hemiarthroplasty to THA is a safe optionwhich can lead to good functional and short-term and mid-term outcomes; and patientsshould be informed of the possibility of incomplete relief of groin pain or other symptomspostoperatively. We also showed that time of primary operation to being symptomatic andinfection in patients had poor prognosis in existence of pain postoperatively.