Total Hip Arthroplasty in a fused hip

Abstract

Purpose : The purpose of this study was to evaluate the clinical and radiographic results of total hip arthroplasty in a fused hip. Material and Method : Out of the 32 cases that nderwent total hip arthroplasty in a fused hip, we reviewed the clinical and radiographic results of 24 hips of 24 patients for a minimum follow-up of two years. Preopreative diagnosis was equale of tuberculous coxitis in 14 cases, sequale of pyogenic coxitis in 8 cases, and sequale of fracture-dislocation of the hip in 2 cases. All hips fused with shortening of the affected limb and flexion contracture. Result : The average Harris hip score improved from 56.2 preoperatively to 93.5 postoperatively. The average lower limb discrepancy improved from 4.2 cm preoperatively to 0.4 cm postoperatively. Radiographically, no radiolucent line was observed between the bone and stem, and vertical subsidence of the stem was not noted. Vertical and horizontal migration of acetabular component by more than 3 mm, and rotational migration above 8 degrees were not noted. Postoperative complications were an intraoperative femoral shaft fracture in 1 case, femoral nerve palsy in 1 case, peroneal nerve palsy in 1 case, and the reactivation of tuberculosis in 1 case. Conclusion : Total hip arthroplasty in a fused hip gave the patients a subjective satisfaction by obtaining joint motion and correcting the fixed deformity. We believe total hip arthroplasty in such patients is a useful treatment, however, long term follow-up is mandatory.