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

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Abstract

[Indexed for MEDLINE] Conflict of interest statement: Declarations. Conflict of interest: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. Ethics approval: The institutional ethics committee approved the study (AIIMS/IEC/22/267). Each author certifies that he or she has no commercial associations (e.g., consultancies, stock ownership, equity interest, patent/licensing arrangements, etc.) that might pose a conflict of interest in connection with the submitted article. The study was conducted in All India Institute of Medical Sciences, Rishikesh, India. Consent to participate: Informed consent was obtained from all individual participants included in the study. 16. Bone Jt Open. 2025 Feb 14;6(2):195-205. doi: 10.1302/2633-1462.62.BJO-2024-0188.R1. Outcomes of conversion total hip arthroplasty following previous hip fracture surgery. Selim A(1)(2), Dass D(3), Govilkar S(3), Brown AJ(3), Bonde S(1), Burston B(1), Thomas G(1)(2). Author information: (1)The Robert Jones and Agnes Hunt Orthopaedic Hospital, Oswestry, UK. (2)School of Medicine, Keele University, Keele, UK. (3)University Hospital North Midlands NHS Trust, Stoke-on-Trent, UK. AIMS: The conversion of previous hip fracture surgery to total hip arthroplasty (CTHA) can be surgically challenging with unpredictable outcomes; reported complication rates vary significantly. This study aimed to establish the medium-term survival and outcomes of CTHA performed following a previous hip fracture surgery. METHODS: All CTHAs performed at our tertiary orthopaedic institution between January 2008 and January 2020 following previous ipsilateral hip fracture surgery were included. Patients were followed up clinically using Oxford Hip Scores (OHS), and radiologically until death or revision surgery. Postoperative complications, radiological implant failure, and indications for revision surgery were reviewed. RESULTS: A total of 166 patients (167 hips) were included in the study, with a mean age of 71 years (42 to 99). Of these, 113 patients (67.7%) were female. CTHA followed cannulated screw fixation in 75 cases, hemiarthroplasty in 18, dynamic hip screw fixation in 47, and cephalomedullary nail in 27 cases. Patients were followed up for a mean of four years (0.1 to 9.3). During the follow-up period, 32 patients (19.2%) died. Overall, 14 patients (8.4%) suffered a complication of surgery, with intraoperative fractures (4.2%) and dislocations (3.6%) predominating. The survival probability was 96% at 9.53 years in the cemented group and 88% at 9.42 years in the uncemented group (p = 0.317). The median OHS improved from 13 (IQR 7.75 to 21.25) preoperatively to 39 (IQR 31 to 45) postoperatively in the uncemented group, and from 14 (IQR 10.5 to 22) to 38 (IQR 27 to 45) in the cemented group. CONCLUSION: This study highlights that CTHA from hip fracture surgery is associated with higher complication rates than conventional THA, but good medium-term results can be achieved. Their classification within the NJR requires review, acknowledging the increased potential for complications. © 2025 Selim et al. DOI: 10.1302/2633-1462.62.BJO-2024-0188.R1 PMCID: PMC11825188