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Total hip arthroplasty for failed aseptic Austin Moore prosthesis.

Bhosale P, Suryawanshi A, Mittal A - Indian J Orthop (2012)

Bottom Line: Average Harris Hip Score improved from 65 preoperatively (range 42-73) to 87 (range 76-90) at 1 year postoperatively and to 86 (range 75-89) at the last followup.The overall complication rate was 4.5%.Conversion THA is an excellent treatment strategy for symptomatic failed AM hemiarthroplasty in terms of pain relief and restoration of function and mobility as near as possible to the preinjury level.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedics, Seth GS Medical College and KEM Hospital, Parel, Mumbai, India.

ABSTRACT

Background: Though Austin Moore (AM) replacement prosthesis has fairly good short term results for intracapsular femoral neck fractures in the elderly, it still is a compromised option and has a high failure rate in the long run. The objective of the present retrospective study is to analyze the functional outcome, assess survivorship of revision total hip arthroplasty (THA) at mid to long term followup, and evaluate intraoperative difficulties faced during conversion of failed aseptic AM prosthesis to cemented THA.

Materials and methods: Eighty-nine cemented THA surgeries for failed AM prosthesis were performed between 1986 and 2005. AM failures were classified into seven groups on the basis of mode of failure. Infected failures were excluded from the study. There were 35 men and 54 women in the study group. The mean age was 68 years (range 57-91 years). Mean followup was 8 years (range 5-13 years).

Results: Average Harris Hip Score improved from 65 preoperatively (range 42-73) to 87 (range 76-90) at 1 year postoperatively and to 86 (range 75-89) at the last followup. The overall complication rate was 4.5%.

Conclusion: Conversion THA is an excellent treatment strategy for symptomatic failed AM hemiarthroplasty in terms of pain relief and restoration of function and mobility as near as possible to the preinjury level. Also, hemiarthroplasty should not be used in physically active patients, even in elderly individuals. Careful patient selection for hemiarthroplasty versus THA is vital and may decrease the incidence of complications and ameliorate the outcomes in the treatment of intracapsular femoral neck fractures.

No MeSH data available.


Related in: MedlinePlus

(a) Radiograph showing erosion of the acetabulum leading to protrusion which was (b) revised to total hip arthroplasty (3 year postoperative radiograph)
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Figure 5: (a) Radiograph showing erosion of the acetabulum leading to protrusion which was (b) revised to total hip arthroplasty (3 year postoperative radiograph)

Mentions: Group 4 (n=19): The patients had protrusion acetabuli [Figure 5] which was treated with impaction bone grafting (autogenous iliac crest bone graft preferred over allograft) using impactor and reverse reaming. In severe cases, we used antiprotrusion cages (n=3). The outer wall of the ilium is exposed for several centimeters above the bone defect, and the residual bone surfaces are roughened with a burr, reamers, or an osteotome. Morsellized pieces of bone graft are then packed into bone defects, leaving room for the antiprotrusion cages.


Total hip arthroplasty for failed aseptic Austin Moore prosthesis.

Bhosale P, Suryawanshi A, Mittal A - Indian J Orthop (2012)

(a) Radiograph showing erosion of the acetabulum leading to protrusion which was (b) revised to total hip arthroplasty (3 year postoperative radiograph)
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3377140&req=5

Figure 5: (a) Radiograph showing erosion of the acetabulum leading to protrusion which was (b) revised to total hip arthroplasty (3 year postoperative radiograph)
Mentions: Group 4 (n=19): The patients had protrusion acetabuli [Figure 5] which was treated with impaction bone grafting (autogenous iliac crest bone graft preferred over allograft) using impactor and reverse reaming. In severe cases, we used antiprotrusion cages (n=3). The outer wall of the ilium is exposed for several centimeters above the bone defect, and the residual bone surfaces are roughened with a burr, reamers, or an osteotome. Morsellized pieces of bone graft are then packed into bone defects, leaving room for the antiprotrusion cages.

Bottom Line: Average Harris Hip Score improved from 65 preoperatively (range 42-73) to 87 (range 76-90) at 1 year postoperatively and to 86 (range 75-89) at the last followup.The overall complication rate was 4.5%.Conversion THA is an excellent treatment strategy for symptomatic failed AM hemiarthroplasty in terms of pain relief and restoration of function and mobility as near as possible to the preinjury level.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedics, Seth GS Medical College and KEM Hospital, Parel, Mumbai, India.

ABSTRACT

Background: Though Austin Moore (AM) replacement prosthesis has fairly good short term results for intracapsular femoral neck fractures in the elderly, it still is a compromised option and has a high failure rate in the long run. The objective of the present retrospective study is to analyze the functional outcome, assess survivorship of revision total hip arthroplasty (THA) at mid to long term followup, and evaluate intraoperative difficulties faced during conversion of failed aseptic AM prosthesis to cemented THA.

Materials and methods: Eighty-nine cemented THA surgeries for failed AM prosthesis were performed between 1986 and 2005. AM failures were classified into seven groups on the basis of mode of failure. Infected failures were excluded from the study. There were 35 men and 54 women in the study group. The mean age was 68 years (range 57-91 years). Mean followup was 8 years (range 5-13 years).

Results: Average Harris Hip Score improved from 65 preoperatively (range 42-73) to 87 (range 76-90) at 1 year postoperatively and to 86 (range 75-89) at the last followup. The overall complication rate was 4.5%.

Conclusion: Conversion THA is an excellent treatment strategy for symptomatic failed AM hemiarthroplasty in terms of pain relief and restoration of function and mobility as near as possible to the preinjury level. Also, hemiarthroplasty should not be used in physically active patients, even in elderly individuals. Careful patient selection for hemiarthroplasty versus THA is vital and may decrease the incidence of complications and ameliorate the outcomes in the treatment of intracapsular femoral neck fractures.

No MeSH data available.


Related in: MedlinePlus