RT Journal Article
SR Electronic
T1 A population study in the Province of Ontario of the complications after conversion of hip or knee arthrodesis to total joint replacement
JF Canadian Journal of Surgery
JO CAN J SURG
FD Canadian Medical Association
SP 433
OP 439
VO 42
IS 6
A1 Hans J. Kreder
A1 Jack I. Williams
A1 Susan Jaglal
A1 Tami Axcell
A1 David Stephen
YR 1999
UL http://canjsurg.ca/content/42/6/433.abstract
AB Objective: To evaluate the complication rates after conversion of hip and knee fusions to total joint replacements in the Province of Ontario.Design: A retrospective cohort study.Patients: Those who had undergone an elective conversion of a hip or knee fusion to a total joint replacement during fiscal year 1993 through 1996, as captured in the Canadian Institute for Health Information and Ontario Health Insurance Plan databases.Outcome measures: Inhospital complications and length of initial hospital stay, revision, infection, amputation and repeat fusion rates within 4 years.Results: Conversion of hip and knee fusion to total joint arthroplasty was generally performed by high-volume surgeons in high-volume hospital settings. Forty hip and 18 knee replacements involved conversion of a previous fusion. Conversion of a hip fusion was associated with a 10% infection rate, a 10% revision rate and a 5% resection arthroplasty rate due to infection within 4 years of the conversion. Conversion of a knee fusion was associated with an 11% infection rate, and a more than 5% revision rate at 4 years. Over 16% of patients who underwent conversion of a knee fusion required removal of the components (for various reasons) within the first 4 years.Conclusions: There is a high rate of complications after conversion of a hip or knee fusion to a total joint arthroplasty. These issues must be carefully considered and discussed with the patient before any conversion procedure.