Abstract
Hip fusion used to be a common procedure in children and young adults, but it is now exceedingly rare.
My results of hip fusion takedown more than 20 years ago were quite acceptable. Of 20 cases, 88% achieved more than 90 degrees of flexion and 75% stopped limping by the end of one year. The elderly would revert to limping when tired.
As no simple hips are currently fused, the results of hip fusion takedown in the last 20 years are very much inferior. Of 28 cases, limp is absent in 20%, mild in 12% and severe in 68%. Range of motion is acceptable with 80% eventually achieving more than 90 degrees of flexion.
There are complications, but these are quite manageable. The aseptic loosening rate is small and the longevity is high. Current implants, therefore, can easily handle the hip fusion takedown.
As the incidence of limp is prohibitively high, additional techniques to reinforce the hip abductors either concurrently or more likely as a secondary procedure as suggested by Whiteside should be learned by all those proposing to carry out hip fusion takedown.
