Role of hip arthrodesis in current practice: long term results following conversion to total hip arthroplasty

Background: Hip arthrodesis was once considered as a preferred treatment option in young people with hip arthritis. The purpose of this retrospective study was to evaluate the long term outcome following conversion of hip arthrodesis to arthroplasty. The main indications for conversion were back pain and ipsilateral muscular or knee pain. Methods: Sixty-eight procedures in 67 patients performed between 1963 and 2000 at Wrightington Hospital were evaluated. Results: The mean age at the time of hip arthrodesis was 16.7 years (3 to 39 years). The mean age at the time of conversion was 48.7 years (24 to 74 years). The Merle d'Aubigne score improved from a mean of 8.81 pre-operatively to 13.6 at the latest follow-up. Complications included DVT (3 patients), transient foot drop (1 patient), and hepatitis following blood transfusion (1 patient). Seven patients required further revision surgery following conversion. Conclusions: Arthrodesis remains a sensible and safe treatment option maintaining independent mobility without multiple operations or significant bone loss for 20-30 years which subsequently can be successfully converted to an arthroplasty. (Hip Int 2008; 18: 263-71)