Salvage Hip Arthroplasty After Failed Fixation of Proximal Femur Fractures |
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Authors: | Alexander M DeHaan Tahnee Groat Michael Priddy Thomas J Ellis Paul J Duwelius Darin M Friess Amer J Mirza |
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Institution: | 1. Department of Orthopaedics and Rehabilitation, Oregon Health and Science University, Portland, Oregon;2. Department of Orthopaedics, The Ohio State University Medical Center, Columbus, Ohio;3. Orthopaedic and Fracture Clinic, Portland, Oregon |
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Abstract: | We reviewed 46 patients who underwent salvage hip arthroplasty (SHA) for revision of failed cannulated screws (CS), sliding hip screws (SHS), or intramedullary nails (IMN). The primary objective was to determine differences in operative difficulty. SHA after failed femoral neck fixation was associated with lower intra-operative demands than after failed peri-trochanteric fractures. Similarly, analysis by the index implant found that conversion arthroplasty after failed CSs was associated with lower intra-operative morbidity than failed SHSs or IMNs; differences between SHS and IMN were not as clear. Importantly, intra-operative data in cases of failed SHSs were similar regardless of the original fracture type, showing the device played a larger role than the fracture pattern. Complications and revision surgery rates were similar regardless of fracture type or fixation device. Our results suggest that operative demands and subsequent patient morbidity are more dependent on the index device than the fracture pattern during SHA. |
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Keywords: | revision hip arthroplasty salvage hip arthroplasty conversion hip arthroplasty failed internal fixation proximal femur fracture hip fracture |
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