ARTHRODESIS OF THE HIP JOINT

A Follow-up Study

¹ NEW YORK, N. Y.

1. An analysis was made of 117 patients in whom hip-joint arthrodesis was performed in one Clinic.

2. The pseudarthrosis rate for the entire group was 23 per cent. and the mortality rate was 3.4 per cent. All deaths occurred in the osteo-arthritis group.

3. The rate of infection was 6 per cent.

4. Not all pseudarthroses are incapacitating. Of the fifteen cases in this series in which pseudarthroses ultimately developed, eight patients were relatively asymptomatic.

5. Back pain was present in all age groups following arthrodesis.

6. The gait was deliberate and acceptable in patients with neutral abductionadduction without shortening.

7. The most normal gait resulted in patients with very slight adduction and no shotening.

8. The poorest gait was in patients with equal limb lengths and abduction; this created a relative lengthening of the fused side, not compensated for by the opposite extremity.

9. It appeared that the most certain method of producing arthrodesis was (a) intra-articular fusion, plus a bone graft, plus a nail of the Smith-Petersen type for internal fixation; or (b) intra-articular fusion plus the insertion of three Vitallium nails.

10. The first attempt to repair pseudarthroses of the hip resulted in 50 per cent. of failures.

11. It has definitely been demonstrated that bony fusion may occur after two years without further surgery.

12. The patients in this study were decidedly benefited by hip arthrodesis.

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