Abstract
Purpose
This study was undertaken to assess the result of total hip arthroplasty (THA) performed for fused hips.
Patients and Methods
Twenty nine patients (31 hips), aged 21 to 70 years (average 46 years), underwent THA conversion surgery and were followed for an average of 4.6 years (2.4-12.0 years). There were 23 cases of spontaneous fusion and 8 case of surgical fusion. The causes of joint fusion were tuberculosis in 6 hips, childhood coxitis in 13, ankylosing spondylitis in 6 and childhood trauma in 4. Modified two incision technique was used in 9 hips and in 22 hips, the surgery was performed through a posterolateral approach combined with anterior capsulotomy through gluteus medius and tensor fasica lata interval. In 1 case, greater trochanter osteotomy was done. All acetabular components were inserted at the true acetabulum and the articulations were metal on metal in 7 cases and ceramic on ceramic in 24 cases. Postoperatively, range of motion exercises were encouraged after 2 to 3 weeks of bed rest and subsequent weight bearing crutch ambulation. Then active exercises were strongly encouraged to stretch abductors. We evaluated the clinical and radiological results.
Results
Mean duration of surgery was 178.6 minutes, and mean perioperative blood loss was 1420.1 ml. Post-operative dislocation occurred in 1 case and partial femoral nerve palsy developed in 1 case. Mean Harris Hip Score improved from 42.4 to 84.2 and mean leg lengthening of 36.6 mm was achieved. Sitting cross legged was possible in 15 patients and except 2 patients, all patients were satisfied with the surgery. On the radiologic evaluation, there was no changes in cup position and there was one case with acetabular focal osteolysis. Postoperative dislocation occurred in one case and there was no revision surgery or infection.
Conclusion
Our study suggest that THA performed for fused hips with hard bearing articulation can provide good clinical and radiological results in mid-term follow up.
