Midterm Results of Conversion from Failed Bipolar Hemiarthroplasty to Total Hip Arthroplasty

Overview

Journal Indian J Orthop

Publisher Springer Nature

Specialty Orthopedics

Date 2018 Aug 7

PMID 30078894

Citations 6

Authors

Kyung-Soon Park

Chee-Ken Chan

Dong-Hyun Lee

Taek-Rim Yoon

Affiliations

Soon will be listed here.

Abstract

Background: Conversion from failed bipolar hemiarthroplasty (HA) to total hip arthroplasty (THA) presents a great challenge to orthopedic surgeons for bipolar head removal and cup placement with or without change of femoral stem. Conversion THA after failed bipolar arthroplasty is known to offer both symptomatic and functional improvement. This study evaluates the midterm functional outcome and complications, especially dislocation associated with femoral head diameter, after conversion THA.

Materials And Methods: Forty eight hips with the conversion of bipolar HA to THA were followed up for an average 6.2 years (range 2.0-11.5 years). Twenty one hips had conversion surgery to THA using metal-on-metal articulation (28 or 32 mm head). Nine hips used ceramic-on-ceramic (28-40 mm) and eighteen hips used large head metal-on-metal bearing (>40 mm). Outcome was evaluated using Harris Hip Score (HHS) and Western Ontario McMaster Universities Osteoarthritis Index (WOMAC) score. The radiographs were analyzed for evidence of osteolysis and/or loosening. The complications were evaluated, especially dislocation with different femoral head diameter.

Results: Average HHS significantly improved from 42 preoperatively to 86 postoperatively and the average WOMAC score also significantly improved from 47 to 22 postoperatively. Radiological evaluation showed all the femoral components were stable. There was one acetabular component loosening, which required revision 9 years after conversion to THA. One dislocation and one recurrent dislocation were recorded in isolated acetabular revision hip; whereas one dislocation, one recurrent dislocation, and one trochanteric nonunion occurred in the hips with revision of both components. All dislocations occurred in hips with a femoral head size of 28 mm ( = 0.052). The cup and femoral head interval length was the most significant factor contributing to dislocation ( = 0.013).

Conclusions: Conversion THA after failed bipolar HA offers a reliable pain relief and functional improvement. To prevent dislocation, it is highly recommended to use a larger diameter femoral head, especially where the cup size is big.

Citing Articles

Outcome of hemiarthroplasty to total hip arthroplasty conversion: a systematic review.

Ansari S, Gupta T, Pranav J, Gupta K, Raja B, Biswas A Musculoskelet Surg. 2025; .

PMID: 39979523 DOI: 10.1007/s12306-025-00895-9.

Outcomes and Management of Dislocated Hip Hemiarthroplasty.

Saxena P, Amanullah N, Rajagopalan S, Ashwood N Cureus. 2024; 16(10):e70928.

PMID: 39502991 PMC: 11537777. DOI: 10.7759/cureus.70928.

Conversion of a Failed Hip Hemiarthroplasty to Total Hip Arthroplasty: A Systematic Review and Meta-Analysis.

Poursalehian M, Hassanzadeh A, Lotfi M, Mortazavi S Arthroplast Today. 2024; 28:101459.

PMID: 39100418 PMC: 11295470. DOI: 10.1016/j.artd.2024.101459.

A Case of a Failed Hemiarthroplasty of the Hip Treated by an Extended Trochanteric Osteotomy.

Nair A, Gupta A, Phalak M, Chopra S Cureus. 2024; 16(5):e60948.

PMID: 38910740 PMC: 11193671. DOI: 10.7759/cureus.60948.

The outcomes of conversion of hemiarthroplasty to total hip arthroplasty, a systematic review and meta-analysis.

Schmitz P, van Susante J, Sierevelt I, Somford M Arch Orthop Trauma Surg. 2024; 144(7):2993-3001.

PMID: 38904682 DOI: 10.1007/s00402-024-05385-4.

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