Skip to main content

Main menu

  • Home
  • Content
    • Current issue
    • Past issues
    • Sections
    • Collections
  • Podcasts
  • Author Info
    • Overview for authors
    • Publication fees
    • Forms
    • Editorial policies
    • Submit a manuscript
    • Open access
  • Careers
  • Alerts
    • Email alerts
    • RSS
  • About
    • General information
    • Staff
    • Editorial Board
    • Contact
  • CMAJ JOURNALS
    • CMAJ
    • CMAJ Open
    • JAMC
    • JPN

User menu

Search

  • Advanced search
CJS
  • CMAJ JOURNALS
    • CMAJ
    • CMAJ Open
    • JAMC
    • JPN
CJS

Advanced Search

  • Home
  • Content
    • Current issue
    • Past issues
    • Sections
    • Collections
  • Podcasts
  • Author Info
    • Overview for authors
    • Publication fees
    • Forms
    • Editorial policies
    • Submit a manuscript
    • Open access
  • Careers
  • Alerts
    • Email alerts
    • RSS
  • About
    • General information
    • Staff
    • Editorial Board
    • Contact
  • Subscribe to our alerts
  • RSS feeds
  • Follow CJS on Twitter
Original Article

A population study in the Province of Ontario of the complications after conversion of hip or knee arthrodesis to total joint replacement

Hans J. Kreder, Jack I. Williams, Susan Jaglal, Tami Axcell and David Stephen
CAN J SURG December 01, 1999 42 (6) 433-439;
Hans J. Kreder
*Assistant Professor, Division of Orthopedic Surgery, University of Toronto, Sunnybrook and Women’s College Health Sciences Centre, Toronto, Ont.
†Department of Public Health Sciences, University of Toronto, and the Clinical Epidemiology and Health Care Research Program, Sunnybrook and Women’s College Health Sciences Centre, Toronto, Ont.
‡Department of Health Administration, University of Toronto, Toronto, Ont.
§Recipient of a career development award from the Orthopaedic Research and Education Foundation, Toronto, Ont.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Jack I. Williams
†Department of Public Health Sciences, University of Toronto, and the Clinical Epidemiology and Health Care Research Program, Sunnybrook and Women’s College Health Sciences Centre, Toronto, Ont.
‡Department of Health Administration, University of Toronto, Toronto, Ont.
¶Department of Family and Community Medicine, University of Toronto. Graduate Department of Community Health, Institute of Medical Science. Graduate Department of Nursing Science. Graduate Department of Rehabilitation Science, Toronto, Ont.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Susan Jaglal
**Research Scientist, M.E. Mueller Program
††Supported by a career scientist award from the Ontario Ministry of Health
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Tami Axcell
‡‡Institute for Clinical Evaluative Sciences, Toronto, Ont.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
David Stephen
*Assistant Professor, Division of Orthopedic Surgery, University of Toronto, Sunnybrook and Women’s College Health Sciences Centre, Toronto, Ont.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Figures & Tables
  • Responses
  • Metrics
  • PDF
Loading

Article Figures & Tables

Tables

    • View popup
    Table I

    Demographics and Crude Complication Rates After Total Hip Replacement With and Without Previous Hip Fusion

    Demographic factorFusionNo fusion
    Mean age, yr58.566.9*
    Follow-up, yr2.52.5
    Male sex, %6043†
    Diagnosis not osteoarthritis, %47.58.9‡
    Comorbid conditions > 1, %02.7
    Mean hospital volume, no./yr181136†
    Mean surgeon volume, no./yr7660†
    Mean length of hospital stay, d10.310.3
    Complication present at index admission, %4510.9‡
    Revision within 4 yr, %101.8*
    Infection within 4 yr, %101.3§
    Girdlestone procedure performed within 4 yr, %50.3§
    Urinary tract infection at index admission, %02.1
    Deep venous thrombosis within 3 mo of index admission, %02.2
    • Student’s t-test was used for continuous variables, the χ2 test for categorical variables (with continuity correction). Fisher’s exact test was used when 1 or more cells had fewer than 5 expected counts. Comparisons between patients who underwent hip fusion takedown and those who did not may be biased since no adjustment was made for other potentially confounding factors.

    • ↵* p < 0.01,

    • ↵† p < 0.05,

    • ↵‡ p < 0.0001,

    • ↵§ p < 0.001

    • View popup
    Table II

    The Odds of Complications After Total Hip Replacement for Patients With and Without Previous Hip Fusion

    OutcomeOdds ratio (with:without fusion)95% confidence interval
    Girdlestone resection14.93.1–70.6
    Infection6.92.3–20.3
    Complications during index admission63.1–11.5
    Revision4.91.7–14.3
    • An odds ratio > 1 implies that the complication is more likely to occur after conversion of a previous hip fusion. In all cases the estimate is adjusted for age, gender, diagnosis, comorbidity, admission year, follow-up time, and surgeon and hospital volume. All odds ratios are statistically significant at p < 0.05.

    • View popup
    Table III

    Demographics and Crude Complication Rates After Total Knee Replacement With and Without Previous Knee Fusion

    Demographic factorFusionNo fusion
    Mean age, yr60.969.6*
    Follow-up, yr2.82.4
    Male sex, %61.138.0†
    Diagnosis not osteoarthritis, %33.38.8*
    Comorbid conditions > 1, %11.13.2§
    Mean hospital volume, no./yr106.8143.9
    Mean surgeon volume, no./yr38.549.5
    Mean length of hospital stay, d13.110.3†
    Complication present at index admission, %22.210.3
    Revision within 4 yr, %5.62.0
    Fusion or re-fusion within 4 yr, %11.10.1‡
    Excision within 4 yr, %16.70.8‡
    Patellar replacement or patelloplasty. %27.885.3‡
    Infection within 4 yr, %11.12.2
    Urinary tract infection at index admission, %5.62.0
    Deep venous thrombosis within 3 mo of index admission, %5.62.6
    • Student’s t-test was used for continuous variables, the χ2 test for categorical variables (with continuity correction). Fisher’s exact test was used when 1 or more cells had fewer than 5 expected counts. Comparisons between patients who underwent hip fusion takedown and those who did not may be biased since no adjustment was made for other potentially confounding factors.

    • ↵* p < 0.01,

    • ↵† p < 0.05,

    • ↵‡ p < 0.0001,

    • ↵§ p < 0.001

    • View popup
    Table IV

    The Odds of Complications After Total Knee Replacement for Patient With and Without Previous Knee Fusion

    OutcomeOdds ratio (with:without fusion)95% confidence interval
    Knee resection arthroplasty15.84.3–58.5
    Infection4.00.9–17.8
    Complications during index admission2.70.9–8.3
    Revision1.90.25–14.5
    Repeat fusion of the knee82.015.3–44.2
    • An odds ratio > 1 implies that the complication is more likely to occur after conversion of a previous knee fusion. In all cases the estimate is adjusted for age, gender, diagnosis, admission year, follow-up time, and surgeon and hospital volume. A 95% confidence level that includes 1 suggests that the result was not significant at p < 0.05. Significant findings are highlighted.

    • View popup
    Table V

    Experience With Hip Fusion Conversion to Total Hip Arthroplasty Since 1980

    Demographic factorSeries
    Current studyReikeras et al, 199531Kilgus et al, 199012Strathy and Fitzgerald, 198813Cameron and Jung, 198710Hardinge et al 198611Lubahn et al 19806
    No. of joints404641801311217
    Surgically fused, %NANA31.78010065.229.4
    Follow-up, yr1–45–1379–151–92–19< 9
    Mean age, yr58.5585349.849NA58.5
    Male, %6019.648.8NA53.8NA70.6
    Infection, %1009.811.301.85.9
    Excision, %0001.3005.9
    Revision, %1015.202502.75.9
    Repeat fusion, %0000000
    FunctionNA74% needed aids after (none before), 76% good & excellentFewer aids45% good or excellent69.2% good and excellentRelief of back pain and functionRelief of back and ipsilateral knee pain
    Mean range of movement (flexion)NANA87°NA88°NA72°
    • The information presented in the table is taken from English-language publications since 1980 reporting on at least 10 patients after conversion of a hip fusion to a total joint replacement.

    • View popup
    Table VI

    Experience With Knee Fusion Conversion to Total Knee Arthroplasty Since 1980

    Demographic factorSeries
    Current studyNaranja et al, 199620Cameron and Hu, 199616Bradley et al, 198714
    No. of joints1837179
    Follow-up, yr1–40–201–102–6
    Mean age, yr60.95359.155
    Male, %61.12058.811.1
    Infection, %11.113.5180
    Excision, %16.71*00
    Revision, %5.624.31211.1
    Repeat fusion, %11.15.411.80
    FunctionNA42.9% housebound58.8% good or excellentLonger Walking tolerance
    Mean range of movement (flexion)NA−7°–62°0–84°2°–64°
    • The information presented in the table is taken from English-language publications since 1980 reporting on at least 10 patients after conversion of a knee fusion (0° of preoperative motion) to a total joint replacement.

    • ↵* Above knee amputation

PreviousNext
Back to top

In this issue

Canadian Journal of Surgery: 42 (6)
CAN J SURG
Vol. 42, Issue 6
1 Dec 1999
  • Table of Contents
  • Table of Contents (PDF)
  • Index by author

Article tools

Respond to this article
Print
Download PDF
Article Alerts
To sign up for email alerts or to access your current email alerts, enter your email address below:
Email Article

Thank you for your interest in spreading the word on CJS.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
A population study in the Province of Ontario of the complications after conversion of hip or knee arthrodesis to total joint replacement
(Your Name) has sent you a message from CJS
(Your Name) thought you would like to see the CJS web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Citation Tools
A population study in the Province of Ontario of the complications after conversion of hip or knee arthrodesis to total joint replacement
Hans J. Kreder, Jack I. Williams, Susan Jaglal, Tami Axcell, David Stephen
CAN J SURG Dec 1999, 42 (6) 433-439;

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
‍ Request Permissions
Share
A population study in the Province of Ontario of the complications after conversion of hip or knee arthrodesis to total joint replacement
Hans J. Kreder, Jack I. Williams, Susan Jaglal, Tami Axcell, David Stephen
CAN J SURG Dec 1999, 42 (6) 433-439;
Digg logo Reddit logo Twitter logo Facebook logo Google logo Mendeley logo
  • Tweet Widget
  • Facebook Like

Related Articles

  • No related articles found.
  • PubMed
  • Google Scholar

Cited By...

  • No citing articles found.
  • Google Scholar

Similar Articles

Collections

  • Arthroplasty

Content

  • Current issue
  • Past issues
  • Collections
  • Alerts
  • RSS

Authors & Reviewers

  • Overview for Authors
  • Publication Fees
  • Forms
  • Editorial Policies
  • Submit a manuscript

About

  • General Information
  • Staff
  • Editorial Board
  • Contact Us
  • Advertising
  • Reprints
  • Copyright and Permissions
  • Accessibility
  • CMA Civility Standards
CMAJ Group

Copyright 2023, CMA Impact Inc. or its licensors. All rights reserved. ISSN 2291-0026

All editorial matter in CJS represents the opinions of the authors and not necessarily those of the Canadian Medical Association or its subsidiaries.

To receive any of these resources in an accessible format, please contact us at CMAJ Group, 500-1410 Blair Towers Place, Ottawa ON, K1J 9B9; p: 1-888-855-2555; e: [email protected].

View CMA's Accessibility policy.

Powered by HighWire