Department of Orthopaedics, Rochester, University of Rochester Medical Center, Rochester, New York, USA.
Iowa Orthop J. 2022;42(2):47-52.
Conversion total hip arthroplasty (cTHA) is increasingly utilized as a salvage procedure for complications associated with fracture fixation around the hip and acetabulum and for failed hip preservation surgery. While primary THA (pTHA) has a high success rate, little is known about outcomes following conversion THA. The purpose of this study is to evaluate patient reported outcomes (PROs) and complication rates following conversion THA compared to primary THA.
Patients that underwent cTHA or pTHA from 2015-2020 at a large tertiary referral academic center were retrospectively identified. THA patients were propensity matched in a 1:1 fashion by age, body mass index (BMI), and sex. Pain scores and PROMIS physical function (PF), pain interference (PI), and depression (DA) scores were compared at preoperative and final postoperative follow up timepoints using independent t-tests. Differences in complication and reoperation rates between cohorts were assessed using chi square analysis.
A total of 118 THAs (59 cTHA, 59 pTHA) were included in this analysis with an average follow up of 21.3 months. cTHAs were most commonly performed following hip fracture fixation (50.8%). The conversion cohort had significantly longer lengths of stay (3.6 days vs 1.9 days, p<0.01) and greater use of revision-type implants (39.0% vs 0.0%, p<0.01) compared to pTHA. There was no significant difference in complication rates (cTHA = 15.3%, pTHA = 8.5%; p=0.26), with intraoperative fracture being the most common for both. Primary and conversion THA groups also experienced similar reoperation rates (cTHA = 5.1%, pTHA = 6.8%; p=0.70). No significant differences in PROs at final follow up were identified between groups.
Patients undergoing cTHA required increased utilization of revision hip implants and had longer lengths of stay, but had comparable complication and reoperation rates, and ultimately demonstrated similar improvements in PROMIS scores compared to a matched cohort of pTHA patients. .
转换全髋关节置换术（cTHA）越来越多地被用作髋关节和髋臼周围骨折固定相关并发症以及髋关节保 存手术失败的挽救性手术。虽然原发性全髋关节置换术（pTHA）成功率较高，但对于转换 THA 后的结果知之甚少。本研究旨在评估与原发性全髋关节置换术相比，转换 THA 后的患者报告结局（PRO）和并发症发生率。
回顾性地确定了 2015 年至 2020 年在一家大型三级转诊学术中心接受 cTHA 或 pTHA 的患者。通过年龄、体重指数（BMI）和性别以 1:1 的比例对 THA 患者进行倾向匹配。使用独立 t 检验比较术前和最终术后随访时间点的疼痛评分和 PROMIS 身体功能（PF）、疼痛干扰（PI）和抑郁（DA）评分。使用卡方分析评估两组之间并发症和再次手术率的差异。
共纳入 118 例 THA（59 例 cTHA，59 例 pTHA），平均随访时间为 21.3 个月。cTHA 最常用于髋关节骨折固定后（50.8%）。与 pTHA 相比，转换组的住院时间明显更长（3.6 天 vs 1.9 天，p<0.01），更常使用翻修型植入物（39.0% vs 0.0%，p<0.01）。两组的并发症发生率无显著差异（cTHA=15.3%，pTHA=8.5%；p=0.26），两者最常见的并发症均为术中骨折。原发性和转换 THA 组的再次手术率也相似（cTHA=5.1%，pTHA=6.8%；p=0.70）。两组在最终随访时的 PRO 无显著差异。
接受 cTHA 的患者需要更多地使用翻修髋关节植入物，住院时间更长，但并发症和再次手术率相似，最终与匹配的 pTHA 患者组相比，PROMIS 评分有相似的改善。
