The Journal of Bone and Joint Surgery, Vol 71, Issue 9 1355-1362, Copyright © 1989 by Journal of Bone and Joint Surgery, Inc
Contralateral total hip arthroplasty or ipsilateral total knee arthroplasty in patients who have a long-standing fusion of the hip
KL Garvin, PM Pellicci, RE Windsor, EU Conrad, JN Insall and EA Salvati
Knee Service and the Hip Service, Hospital for Special Surgery, New York, N.Y. 10021.
We studied the cases of twenty patients who had had an ipsilateral total
knee arthroplasty or a contralateral total hip arthroplasty, or both, long
after one hip had been fused in an acceptable position. Between 1972 and
1986, we performed twenty-one total joint arthroplasties (on thirteen hips
and eight knees) and followed two additional patients (one hip and one
knee) in whom the operation had been performed elsewhere. The average age
of the patients at the time of arthroplasty was fifty-seven years (range,
thirty-one to eighty-one years), and the average time from arthrodesis to
arthroplasty was thirty-two years (range, eleven to fifty-four years). The
results of eighteen of the twenty-three arthroplasties were evaluated at an
average of seven years and nine months postoperatively. Four of the
remaining five patients, who were followed for an average of eight years,
died of a cause that was unrelated to the arthroplasty. After the hip
arthroplasty, five hips were rated excellent; five, good; one, fair; and
three, poor. Each hip that had a poor result was revised twice for
mechanical loosening. Three hips for which the result was not considered
poor had progressive radiolucency. After the knee arthroplasty, three knees
were rated excellent; four, good; one, fair; and one, poor (because of
infection). Seven knees were manipulated a total of fifteen times. Only one
patient had progressive symptomatic radiolucency, nine years after the
insertion of a posterior stabilized prosthesis. Clinically important
ligamentous instability was not encountered.(ABSTRACT TRUNCATED AT 250
WORDS)
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