Abstract
Introduction: A retrospective audit to evaluate the results of Austin Moore hemiarthroplasty conversion to Total hip arthroplasty for suspected aseptic loosening.
Materials and Methods: A consecutive cohort of patients who had conversion of Austin-Moore hemiarthroplasty to Total hip arthroplasty performed at our district general hospital between August 2000 and May 2006 were included in the study.
The total of 41 patients were divided into two groups depending on the duration between the primary hemiarthroplasty procedure and its revision to total hip arthroplasty – (1) Less than one year (16 patients) and (2) More than one year (25 patients).
The data collected included: age, sex, classification of the fracture, date of primary operation, surgical approach, inflammatory markers, indication and date of revision to total hip arthroplasty, and the final outcome.
Results: The rate of infection after the revision to total hip arthroplasty was found to be 25% (4/16 patients) in patients who underwent the revision operation within 1 year after the primary operation, whereas the infection rate was 8% (2/25 patients) for those who had the revision operation more than a year after the primary operation. The difference in infection rates between the two groups was found to be statistically significant despite the small numbers.
Discussion: The patients who have early loosening of the Austin-Moore hemiarthroplasty within the 1 year of the primary procedure should raise a suspicion of occult infection. Despite near normal inflammatory markers, a two-staged conversion to total hip arthroplasty should be seriously considered.
Correspondence should be addressed to Mr Bimal Singh, c/o BOSA at the Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London WC2A 3PE
