Abdel M et al. – This study evaluated the unique complications of conversion total hip arthroplasty (THA), implant survivorship free of revision and reoperation, radiographic observations, and clinical outcomes in elderly patients undergoing conversion THA following in situ fixation of non–displaced femoral neck fractures (FNFs). The authors concluded that conversion THA was associated with clinical improvement, low rate of complications, and excellent implant durability. Risks of loosening, dislocation, and periprosthetic fracture can be reduced with perioperative management and suitable operative strategies.

Methods

• Patients (N = 62; aged >65 years; 73% female) who underwent THA following in situ fixation of minimally displaced FNFs (2000–2014) were included in the study.
• The indications were osteonecrosis (44%), post–traumatic/degenerative arthritis (35%), and non–union (21%).
• Mean follow–up was 5.5 years.

Results

• At 11 years, 1 patient was revised for aseptic femoral loosening, and at 10 years, 1 patient underwent debridement and modular component exchange for acute hematogenous prosthetic joint infection (PJI).
• Two patients underwent acute reoperation without component exchange (1 superficial wound infection, 1 hematoma evacuation).
• At 5 years, survivorship free of reoperation for any indication was 97% and none of the patients with surviving implants had radiographic evidence of loosening.
• Following THA, Harris Hip Scores improved from 35 to 85 (P<.01).