ABSTRACT
BACKGROUND: One of the most common surgical options for treatment of a femoral neck fracture is hemiarthroplasty (HA). However, progression of arthritis or pain can necessitate conversion to total hip arthroplasty (THA). While conversion to a THA is a viable option, it does carry multiple risks. The purpose of this study was to identify whether performing conversion from HA to THA carries an increased risk of post-operative joint complications when compared to elective THA. METHODS: An administrative claims database was queried to identify patients who underwent conversion from a HA to a THA. Incidences of prosthetic dislocation, prosthetic joint infection (PJI), periprosthetic fracture, aseptic loosening, and revision were collected and compared to elective primary THA with multivariable logistic regression. RESULTS: Patients undergoing conversion THA had significantly higher risks of all joint complications examined at both 1 and 2 years after surgery. These included prosthetic dislocation (1-year: OR 2.95; 2 years: OR 3.77), PJI (1-year: OR 1.38; 2 years: OR 2.13), periprosthetic fracture (1-year: OR 2.95; 2 years: OR 3.75), aseptic loosening (1-year: OR 6.86; 2 years: OR 7.70), and revision (1-year: OR 3.65; 2 years: OR 6.73). CONCLUSION: Performing conversion arthroplasty from HA to THA is associated with an increased risk of multiple joint complications in both the short and mid-term follow-up period. Surgeons should consider these complications when indicating HA for femoral neck fractures and elective conversion arthroplasty.
