TY - JOUR
T1 - Conversion total hip arthroplasty after previous intertrochanteric hip fractures
T2 - A review of the epidemiology, technical issues, and outcomes
AU - Rinehart, Dustin B.
AU - Fene, Evan S.
AU - Huo, Michael H.
N1 - Publisher Copyright:
© 2022 Lippincott Williams and Wilkins. All rights reserved.
PY - 2022/9/6
Y1 - 2022/9/6
N2 - Conversion total hip arthroplasty (THA) after previous intertrochanteric (IT) hip fracture is a unique operation that is different from the routine primary total hip arthroplasty (THA) done for osteoarthritis or femoral head necrosis. Conversion THAs are similar to revision THAs with regard to complexity, technical challenges, implant costs, and perioperative complications. A literature review was performed with specific focus on the surgical techniques, patient outcomes, and financial burdens of conversion THAs after IT fracture treatment with either a sliding compression hip screw with side plate (SSP), or a cephalomedullary nail (CMN). The reported data demonstrated similar technical challenges regardless of the method of the index treatment of the IT fracture. The surgeon must plan and be prepared for more difficult and extensile exposure, available instruments for the hardware removal, altered proximal femoral geometry, and available implant inventory for the reconstruction. The outcomes are consistent with higher rates of instability and infection in the conversion THAs compared with primary THAs. There is no significant difference in the clinical outcomes of conversion THAs following either SSP or CMN. Overall, conversion THAs pose greater technical challenges. The clinical outcomes of conversion THAs remain inferior to the primary THAs. The complications and patient functional outcomes are similar to those following revision THAs.
AB - Conversion total hip arthroplasty (THA) after previous intertrochanteric (IT) hip fracture is a unique operation that is different from the routine primary total hip arthroplasty (THA) done for osteoarthritis or femoral head necrosis. Conversion THAs are similar to revision THAs with regard to complexity, technical challenges, implant costs, and perioperative complications. A literature review was performed with specific focus on the surgical techniques, patient outcomes, and financial burdens of conversion THAs after IT fracture treatment with either a sliding compression hip screw with side plate (SSP), or a cephalomedullary nail (CMN). The reported data demonstrated similar technical challenges regardless of the method of the index treatment of the IT fracture. The surgeon must plan and be prepared for more difficult and extensile exposure, available instruments for the hardware removal, altered proximal femoral geometry, and available implant inventory for the reconstruction. The outcomes are consistent with higher rates of instability and infection in the conversion THAs compared with primary THAs. There is no significant difference in the clinical outcomes of conversion THAs following either SSP or CMN. Overall, conversion THAs pose greater technical challenges. The clinical outcomes of conversion THAs remain inferior to the primary THAs. The complications and patient functional outcomes are similar to those following revision THAs.
KW - conversion total hip arthroplasty
KW - intertrochanteric hip fracture
KW - revision arthroplasty
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U2 - 10.1097/BCO.0000000000001136
DO - 10.1097/BCO.0000000000001136
M3 - Review article
AN - SCOPUS:85137085903
SN - 1940-7041
VL - 33
SP - 409
EP - 413
JO - Current Orthopaedic Practice
JF - Current Orthopaedic Practice
IS - 5
ER -