Hip arthrodesis. A long-term follow-up.

In a retrospective study, we examined twenty-eight patients who had had an arthrodesis seventeen to fifty years previously (average, thirty-five years). Hip and knee ratings were obtained, as well as anteroposterior and flexion-extension radiographs of the lumbar spine and standing anteroposterior radiographs of the knees and hips. About 60 per cent of the patients had pain in the ipsilateral knee (average time to onset, twenty-three years after arthrodesis), and a similar percentage had back pain (average time to onset, twenty-five years after the operation). Pain in the contralateral hip occurred in approximately 25 per cent of the patients (average time to onset, twenty years after arthrodesis). Only one patient was unemployed due to disabling pain in the back or knee. Seventy per cent of the patients could walk more than one mile (1.6 kilometers), and a similar percentage could sit comfortably for at least two hours. Seventy-five per cent of the patients had anteroposterior laxity of the ipsilateral knee, and 80 per cent had mediolateral laxity. The patients whose hip was fused in some abduction more frequently had pain in the ipsilateral knee and the back, and they had greater degenerative changes in the ipsilateral knee than the patients whose hip was fused in adduction or in the neutral position. Six patients had undergone total hip arthroplasty for pain in the back or the ipsilateral knee, or both, and all had marked relief of back pain, while two of four had relief of pain in the knee. Two patients had a total knee arthroplasty for relief of pain in the ipsilateral knee.