Total hip arthroplasty after hip joint ankylosis.

Abstract

Back pain and knee pain are typical secondary degeneration symptoms after hip ankylosis. Take down of hip ankylosis and implantation of a total hip arthroplasty (THA) is believed to be a promising treatment option. A total of 22 hip ankylosis patients [15 men, mean age 53.7 years (range 30-72 years); 7 women, mean age 50.8 years (range 42-61 years)] underwent THA during 1980-2000 after spontaneous (n = 10) or surgical (n = 12) fusion of the hip joint. The mean duration of ankylosis prior to THA was 32.5 years (range 2-61 years). At the mean follow-up of 13.2 years (range 2-19 years), the Harris hip score averaged 84.9 points (range 70.1-99.0 points). All patients (100%) confirmed that they would undergo conversion surgery again. Aseptic loosening of two stems (one cemented, one cementless; 9.5%) and two deep infections (9.5%) required revision surgery. THA is a promising option for treatment of secondary long-term hip ankylosis sequelae. A conversion operation after spontaneous ankylosis provides better functional outcome than after surgical fusion. However, full function with complete pain relief and a negative Trendelenburg sign might be not attainable in all cases.