Total Hip Arthroplasty After Prior Surgical Treatment of Hip Fracture Is it Always Challenging?

Rothman Institute of Orthopedics at Thomas Jefferson University,Philadelphia, Pennsylvania 19107, USA.
The Journal of arthroplasty (Impact Factor: 2.37). 07/2011; 27(1):31-6. DOI: 10.1016/j.arth.2011.05.014
Source: PubMed

ABSTRACT Salvage total hip arthroplasty (THA) presents a viable solution for failed open reduction internal fixation. This study compares salvage THA in patients with prior femoral neck fractures vs patients with prior intertrochanteric fractures. One hundred fifty-four hips in 152 patients underwent conversion from open reduction internal fixation to THA. Eighty-three patients had previous femoral neck fractures, and 69 patients (71 hips) had prior intertrochanteric fractures. Salvage THA in patients with prior intertrochanteric fractures presented a more technically demanding procedure with longer operative times and larger amounts of blood loss. Although conversion THA presents a technically challenging procedure, it is safe and yields relatively few orthopedic complications.

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    ABSTRACT: Background and aims Hip arthroplasty has been advocated as a salvage procedure after failed nailing of proximal femoral fractures. The aim of the current study was to evaluate chirurgical complications of hip arthroplasty after failed nailing of proximal femoral fractures. The second aim was to compare the complication profile of semiendoprosthesis (SEP) to that of total endoprosthesis (TEP). Materials and methods There were 1,533 Gamma- or DHS-nailed proximal femoral fractures altogether at our institution during the study period 2000–2010. We reviewed the medical records of 51 hips in 50 patients with failed nailing of fracture followed by hip arthroplasty (3.3 % of all nailed proximal femoral fractures). The patients were identified retrospectively from a single academic institution’s computerized database. Results There was at least one re-operation after arthroplasty in ten patients (20 %). Dislocation was the most common reason of the re-operation (six patients). The SEP and TEP groups did not differ significantly from each other with regard the re-operation rate (p = 0.72). Conclusions Failed arthroplasty is common after failed nailing of proximal femoral fractures.
    12/2012; 3(4). DOI:10.1007/s12570-012-0133-7