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Arch Orthop Trauma Surg · Jul 2024
Review Meta AnalysisThe outcomes of conversion of hemiarthroplasty to total hip arthroplasty, a systematic review and meta-analysis.
- Peter P Schmitz, van SusanteJob L CJLCDepartment of Orthopedics, Rijnstate Hospital, postbox 9555, Arnhem, 6800, The Netherlands., Inger N Sierevelt, and Matthijs P Somford.
- Department of Orthopedics, Rijnstate Hospital, postbox 9555, Arnhem, 6800, The Netherlands. PSchmitz@rijnstate.nl.
- Arch Orthop Trauma Surg. 2024 Jul 1; 144 (7): 299330012993-3001.
IntroductionAcetabular erosion is an important complication in hemiarthroplasty and may lead to total hip arthroplasty as a conversion. The results of total hip arthroplasty as a conversion remain unclear. We performed a systematic review and meta-analysis to compare the outcome of total hip arthroplasty as a conversion with primary total hip arthroplasty.Materials And MethodsPRISMA guidelines were used and Pubmed, Embase and the Cochrane libraries were searched. Both, studies comparing the outcome of total hip arthroplasty as a conversion with the outcome of primary total hip arthroplasty and the outcome of cohort studies limited to total hip arthroplasty as a conversion, were included. Risk of bias was assessed using the Methodological Index for Non Randomized Studies checklist. Meta-analysis was performed concerning pooled annual revision, dislocation and infection rates.ResultsA total of 27 studies were available for analysis; four comparative studies and 23 cohort studies. Comparative studies were defined as high quality and cohort studies as medium quality. Analysis revealed a significantly higher overall revision risk (Hazard Ratio 1.72, 95% confidence interval 1.39 to 2.14) after total hip arthroplasty as a conversion compared to primary total hip arthroplasty. The annual revision rate of total hip arthroplasty as a conversion was 1.63% (95% confidence interval 1.14 to 2.33) in the comparative studies and 1.40% (95% confidence interval 1.17 to 1.66) in the cohort studies. A pooled infection rate of 4.34% (95% confidence interval 2.66 to 7.01) and dislocation rate of 4.79% (95% confidence interval 3.02 to 7.53), was found.ConclusionsLiterature concerning the results of total hip arthroplasty as a conversion is limited. The risk of revision after conversion of hemiarthroplasty is higher compared to primary total hip arthroplasty.© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.
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