Conversion of failed hemiarthroplasty to total hip arthroplasty remains high risk for subsequent complications
Journal of Arthroplasty Jun 02, 2019
Hernandez NM, et al. - Among patients (n=389) converted from hemiarthroplasty to total hip arthroplasty, researchers assessed the risks and predictors of complications, dislocations, reoperations, and revisions, as well as focused on the extent of competing risk of mortality when assessing outcomes. They reported 122 complications, 34 dislocations, 69 reoperations, and 51 revisions during an average of 9.3 years of follow-up. A higher risk of reoperations was observed in relation to conversion for periprosthetic fractures. Increasing age conferred risk for reoperations. Either when assessing year of surgery as a continuous variable or when comparing specific calendar year intervals (1985-1989, 1990-1999, 2000-2009, 2010-2014), no reductions in the rate of complications, dislocations, reoperations, or revisions were evident. The risk of revision was overestimated by 7% at 15 years and 10% at 20 years by the Kaplan-Meier method, compared to the total incidence accounting for the competing risk of mortality.
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