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Hip Resurfacing Arthroplasty Failure. Conversion to Total Hip is it a Favorable Solution with Satisfactory Outcomes?

Author(s): Abdel-Hamid A Atallah, Yaser El-Sayed Hassan Wahd, Mohamed A Abdel-AAl

Background: Hip resurfacing arthroplasty (HRA) had been utilized since the 1950s. The concept favoured for selected young active patients with degenerative hip disease owing to its proposed advantages. Revision rate in most national registries nearly 3.5%. Conversion to total hip replacement may be the correct option for old patients and those whose activity levels changed and the need for hip resurfacing no longer required.

 Purpose: The aim of this study is to assess the mid-term outcomes of converting failed hip resurfacing arthroplasty to total hip arthroplasty.

 Study design: Prospective case series study.

 Level of evidence: Therapeutic IV.

 Patients and methods: The study enrolled thirty–five patients (twenty- five males) with failed hip resurfacing arthroplasty converted to total hip arthroplasty Mean age 52.3 years and mean time to revision 35.2 months. Revision included: femoral neck fractures (14 cases), femoral neck thinning (4 cases), component loosening (6 cases) component dislocation (3cases) persistent groin pain and clicking (3 cases) and wear of components (5 cases). Both components revised in Twenty-five patients while the remaining ten underwent revision of femoral component only.

 Results: Mean Preoperative hip scores (Oxford, WOMAC, Harris and UCLA hip scores) were 19.4, 78.3, 33,8 and 4.1 respectively improved at last follow-up to 39.8, 11.1, 92.3 and 8.1 respectively representing statistically significant improvements over pre-operative scores (p < 0.0001 for each score) No cases of neurological, vascular, deep infection or implant failure. There were 3 cases (8.6%) with complications included surgical site infection with serous drainage for more than seven days (one case), heterotopic ossification (one case) and residual groin pain in one case. All patients were satisfied particularly by their pain relief. Average post-operative Oxford, Harris and WOMAC hip scores were 17.4, 89.8 and 6.1 respectively. Representing statistically significant improvements over pre-operative scores (p < 0.0001 for each score).

Conclusions: Conversion of failed hip resurfacing to THA has high satisfaction rates. These results compare favorably with those for revision total hip arthroplasty.

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