0 Item(s)
Conversion of Failed Hemiarthroplasty to Total Hip Arthroplasty
Hemiarthroplasty of the hip is performed primarily for the management of femoral neck fractures. Like any hip arthroplasty, hemiarthroplasties can fail and necessitate revision surgery. Failure rates primarily depend on the implant design and patient age. At 10 years after surgical management of a hip fracture, bipolar hemiarthroplasties have the lowest cumulative revision rate, followed by unipolar modular hemiarthroplasties, and unipolar monoblock hemiarthroplasties. The implant design of a failed hemiarthroplasty affects the options for revision arthroplasty. Failed unipolar monoblock implants always require revision of the stem, irrespective of the cause for revision, whereas failed unipolar or bipolar modular hemiarthroplasties can be managed with an isolated femoral head and acetabular revision, or revision of both the stem and the acetabulum. With any implant, failure of hemiarthroplasty is most commonly managed with conversion to THA. Conversion is most commonly performed for the management of chondrolysis with acetabular erosion, dislocation, fracture, infection, loosening and/or osteolysis, malposition, and pain. The relative incidence of the reasons for revision varies with hemiarthroplasty type. This chapter reviews the indications and contraindications, outcomes, and surgical strategies for conversion of a failed hemiarthroplasty to THA. Postoperative protocols and tips for avoiding pitfalls and complications are also discussed.