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Orthopaedic Proceedings
Vol. 94-B, Issue SUPP_XL | Pages 62 - 62
1 Sep 2012
Hakuta N Tsuchida M Yamaoka K Sunami H Kusaba A Kondo S Kuroki Y
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Introduction

Conversion of immovable hip to a total hip arthroplasty provides a solution, improving function, reducing back and knee pain, and slowing degeneration of neighboring joints associated with hip dysfunction while the mobilization by total hip arthroplasty is rather uncommon and challenging surgery.

Materials and methods

Since 1998 we have performed 28 uncemented total hip arthroplasties for arthrodesed or ankylotic Hip. Among them 25 hips in 24 patients (four males and 20 females) with minimum of six months follow-up were evaluated. Thirteen hips were arthrodesed and twelve hips were ankylotic. One patient had arthrodesed hip in one side and ankylotic one in the other side. The mean age at the surgery was 63 (42 to 80). Two patients were Jehovah's witnesses. All 13 arthrodeses had been performed at other hospitals due to developmental dysplasia (11 hips), tuberculous coxitis (one hip), and infection after osteotomy (one hip). The underlying disease for the ankylosis was tuberculous coxitis for one hip and dysplastic osteoarthritis for 12 hips. Spongiosa Metal Cup (GHE, ESKA Orthodynamics AG, Lübeck, Germany) was used for 21 hips (screw fixation was added for two hips), Alloclassic Cup (Zimmer GmbH, Winterthur, Switherland) for one hip, Bicon Plus Cup (Smith & Nephew AG, Rotkreuz, Switherland) for one hip, and Müller's Reinforcement Ring (Zimmer GmbH, Winterthur, Switherland) for two hips. The bearing couple was ceramic on ceramic (Biolox forte, Ceramtec AG, Prochingen, Germany) for 14 hips, ceramic on polyethylene for eight hips, and metal on metal for three hips. Spongiosa Metal Stem (GHE, ESKA Orthodynamics AG, Lübeck, Germany) was used for 15 hips, SL Plus Stems (Smith & Nephew AG, Rotkreuz, Switherland) for nine hips, and Alloclassic Stem (Zimmer GmbH, Winterthur, Switherland) for one hip. All surgeries were carried out through an anterolateral approach. Twelve hips required the adductor tenotomy against the stiffness. The average follow-up period was 3.7 (0.5 to 10.6) years.