Aim
The aim of the present study was to evaluate functional results and complications of total hip arthroplasty (THA) performed as a salvage procedure after failed hemiarthroplasty.
Patients and methods
This study reports on 25 patients who had conversion to THA following failed hemiarthroplasty: twenty (80%) cases with Austin Moore prosthesis and five (20%) cases with cemented Thompson prosthesis. There were 10 women and 15 men. Their mean age was 67.96 years (range 56–82 years); the average follow-up period was 29.3 months (range 12–36 months). The main indication for conversion included acetabular erosion with a well-fixed femoral stem in 17 patients, acetabular erosion with femoral loosening in seven patients, and one case with cemented Thompson dislocation. A standard posterior approach to the hip was used in all patients. Bone defects were evaluated and filled with a bone graft if required. The cemented total hip prosthesis was then inserted in all cases.
Results
The patients were evaluated clinically and radiologically. The Harris hip score improved from a mean of 40.2 points preoperatively to a mean of 82.36 points at the last follow-up. The complications included two cases with superficial infection and one case with an intraoperative femoral shaft fracture; cracks of the greater trochanter occurred in two cases during extraction of cemented Thompson. There were no instances of instability or loosening. At the end of follow-up, six cases (24%) showed excellent results, 17 cases (68%) showed good results, and two cases (8%) showed fair results.
Conclusion
Conversion THA appears to be an excellent management strategy for failed hemiarthroplasty, and can lead to reliable pain relief and functional improvement. THA is an effective salvage procedure, but it is technically more difficult than routine primary hip arthroplasty.