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Clinical Research

Hip Arthroplasty after Previous Arthrodesis

Erik D. Peterson1, Joseph P. Nemanich2, Aaron Altenburg3 and Miguel E. CabanelaContact Information

(1)  Orthopaedic Consultants, Sioux Falls, SD, USA
(2)  Minnesota Orthopedic Specialists, Minneapolis, MN, USA
(3)  Idaho Orthopaedic and Sports Clinic, Pocatello, ID, USA
(4)  Mayo Clinic College of Medicine, 200 First Street, SW, Rochester, MN 55905, USA

Received: 10 October 2008  Accepted: 24 July 2009  Published online: 19 August 2009

Abstract  Total hip arthroplasty after previous arthrodesis has been associated with increased complications and decreased survivorship of the prosthesis. We evaluated pain, function, and the factors influencing survivorship of total hip arthroplasties after previous arthrodesis between 1985 and 2000 and compared these results with those obtained in prior years with the same procedure and in the same institution. We retrospectively reviewed 30 patients who had previous spontaneous or surgical arthrodesis. The minimum followup was 2 years (mean, 10.4 years; range 2–20.5 years). Seven failures were identified (23%). The overall survival free of failure was 86% at 5 years and 75% at 10 years. At last followup, 27 of the 30 patients (91%) had no or slight pain, 26 (87%) had a limp, and 18 (61%) needed a gait aid. Surgical arthrodesis, age younger than 50 years at the time of arthroplasty, and length of arthrodesis less than 30 years independently predicted failure. Conversion of arthrodesis to hip arthroplasty reliably decreases pain and improves function, but many patients will limp and require a gait aid. Our outcomes were similar to those after revision rather than after primary hip arthroplasty.
Level of Evidence: Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
Each author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.
Each author certifies that his or her institution has approved the human protocol for this investigation, that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participation in the study was obtained.
This study was performed at Mayo Clinic College of Medicine.

Contact Information Miguel E. Cabanela
Email: cabanela.miguel@mayo.edu

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