TY - JOUR
T1 - Comparison of Differences in Complications and Revision After Conversion to Total Hip Arthroplasty from Plating vs. Nailing vs. Hemiarthroplasty
AU - Sambandam, Senthil
AU - Mounasamy, Varatharaj
AU - Wukich, Dane
N1 - Publisher Copyright:
COPYRIGHT 2022 © BY THE ARCHIVES OF BONE AND JOINT SURGERY.
PY - 2022
Y1 - 2022
N2 - Background: Total hip arthroplasty (THA)after previous hip surgery increases the procedure complexity and complication rate. We investigated the complication rates following conversion to total hip arthroplasty from three hip surgeries, namely plate fixation of the intertrochanteric fracture, nailing of the trochanteric fracture, and hemiarthroplasty of the hip. Methods: This retrospective study was conducted using the PearlDiver database (www.pearldiverinc.com, Colorado Springs) and identified all patients undergoing THA between 2010 and 2019. Among this group, we included all patients who had received one of the three procedures, hip hemiarthroplasty (CPT 27125), fixation of the intertrochanteric fracture with plates and screws (CPT 27444), or fixation of hip fracture with nail (CPT 27445) within two years of THA. We analyzed complications in these patients and compared it to the complication rate in primary THA patients. The complications analyzed were 30-day transfusion risk, 90-day surgical site infection (SSI) risk, 90-day periprosthetic fracture risk, 1-year dislocation risk, and 2-, 5-, and 10-year revision risk. Results: A total of 118,209 patients underwent THA between 2010 and 2019. A total of 9,173, 48,326, and 31,632 patients underwent fixation with plates and screws, nailing and hemiarthroplasty respectively. We identified 71, 42, and 160 patients with hemiarthroplasty, plates & screws, and nailing, respectively, within two years of THA. 117,936 primary THA patients were used as a comparison group. The nailing group had the highest rate of transfusion risk (OR=2.34, 95% CI=1.32, 4.13, P<0.05). Furthermore, the hemiarthroplasty group had highest rate of SSI risk (OR=9.25, 95% CI=4.86, 17.63, P<0.05) and highest revision risk at 2 years (OR=10.532, 95% CI= 6.09, 18.19, P<0.05). Conclusion: Conversion of hemiarthroplasty to THA was associated with a higher risk of infection and revision. Hence, surgeons considering primary hip hemiarthroplasty for severely comminuted intertrochanteric fracture should exercise caution, especially for active elderly patients.
AB - Background: Total hip arthroplasty (THA)after previous hip surgery increases the procedure complexity and complication rate. We investigated the complication rates following conversion to total hip arthroplasty from three hip surgeries, namely plate fixation of the intertrochanteric fracture, nailing of the trochanteric fracture, and hemiarthroplasty of the hip. Methods: This retrospective study was conducted using the PearlDiver database (www.pearldiverinc.com, Colorado Springs) and identified all patients undergoing THA between 2010 and 2019. Among this group, we included all patients who had received one of the three procedures, hip hemiarthroplasty (CPT 27125), fixation of the intertrochanteric fracture with plates and screws (CPT 27444), or fixation of hip fracture with nail (CPT 27445) within two years of THA. We analyzed complications in these patients and compared it to the complication rate in primary THA patients. The complications analyzed were 30-day transfusion risk, 90-day surgical site infection (SSI) risk, 90-day periprosthetic fracture risk, 1-year dislocation risk, and 2-, 5-, and 10-year revision risk. Results: A total of 118,209 patients underwent THA between 2010 and 2019. A total of 9,173, 48,326, and 31,632 patients underwent fixation with plates and screws, nailing and hemiarthroplasty respectively. We identified 71, 42, and 160 patients with hemiarthroplasty, plates & screws, and nailing, respectively, within two years of THA. 117,936 primary THA patients were used as a comparison group. The nailing group had the highest rate of transfusion risk (OR=2.34, 95% CI=1.32, 4.13, P<0.05). Furthermore, the hemiarthroplasty group had highest rate of SSI risk (OR=9.25, 95% CI=4.86, 17.63, P<0.05) and highest revision risk at 2 years (OR=10.532, 95% CI= 6.09, 18.19, P<0.05). Conclusion: Conversion of hemiarthroplasty to THA was associated with a higher risk of infection and revision. Hence, surgeons considering primary hip hemiarthroplasty for severely comminuted intertrochanteric fracture should exercise caution, especially for active elderly patients.
KW - Cephalomedullary nailing
KW - Complication
KW - Conversion hip
KW - Hemiarthroplasty
KW - Plating
KW - Revision
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U2 - 10.22038/ABJS.2021.60893.3000
DO - 10.22038/ABJS.2021.60893.3000
M3 - Article
C2 - 36246028
AN - SCOPUS:85168613258
SN - 2345-4644
VL - 10
SP - 785
EP - 790
JO - Archives of Bone and Joint Surgery
JF - Archives of Bone and Joint Surgery
IS - 9
ER -