Development of Flattening and Apparent Fragmentation Following Ischemic Necrosis of the Capital Femoral Epiphysis in a Piglet Model
| Autor: | John C. M. Murphy, Atul B. Joshi, Kevin Hardinge, Ljubisa Markovic |
|---|---|
| Rok vydání: | 2002 |
| Předmět: |
musculoskeletal diseases
Hip surgery medicine.medical_specialty business.industry medicine.medical_treatment Arthrodesis General Medicine medicine.disease Arthroplasty Prosthesis Confidence interval Surgery Orthopedic surgery medicine Orthopedics and Sports Medicine Heterotopic ossification Range of motion business |
| Zdroj: | The Journal of Bone & Joint Surgery. 84:1329-1334 |
| ISSN: | 0021-9355 |
| DOI: | 10.2106/00004623-200208000-00007 |
| Popis: | Background: Arthrodesis of the hip remains a viable treatment for severe unilateral arthritis after traumatic injury or infection in a young but otherwise healthy individual. The goal of the present study was to review the long-term clinical and radiographic results after conversion of a fused hip to a total hip arthroplasty and to identify the risk factors that would lead to a higher rate of failure. Methods: We performed a retrospective review of the charts and radiographs of 187 patients (208 hips) who had conversion of a fused hip to a total hip arthroplasty. The mean duration of follow-up after the conversion to total hip arthroplasty was 9.2 years (range, two to twenty-six years). Results: The mean age at time of the arthroplasty was fifty-one years. The mean time-interval between the arthrodesis and the conversion to a total hip arthroplasty was twenty-seven years. According to the information in the charts, at a mean duration of follow-up of 9.2 years after the total hip arthroplasty, 79% of hips were either pain-free or had minimal pain, 83% had good-to-excellent function, and 79% had good-to-excellent range of motion. Complications, which included fifteen nerve palsies, occurred in twenty-four hips. Twenty-eight hips had heterotopic ossification, but it was not associated with a recurrence of ankylosis or a marked reduction of motion. Revision arthroplasty was performed in twelve hips. The probability of survival of the implant was 96.1% (95% confidence interval, 91.5% to 98.2%) at ten years, 89.9% (95% confidence interval, 85.3% to 96.1%) at fifteen years, and 72.8% (95% confidence interval, 36% to 90.6%) at twenty-six years. Conclusions: Conversion of a fused hip to a total hip arthroplasty has a favorable outcome. However, the technically demanding nature of the procedure should not be underestimated. Patients should be cautioned with regard to the possibility of a higher rate of complications than that seen with primary total hip arthroplasty. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|