The most common indication for conversion total hip replacement after previous hemiarthroplasty is pain. Pain can result from loosening of the femoral stem, erosion of the acetabulum, a combination of the two and sepsis. More recently, two additional indications are disassembly and wear of modular hemiarthroplasty components
Methodology: A total 22 patients who had conversion of their failed hemiarthroplasty to a total hip replacement in Hospital were analyzed retrospectively and prospectively. Those patients who had been operated with hemiarthroplasty for diagnosis other than fracture neck of femur were excluded from the study. All patients were evaluated clinically and radiologically with review of serial follow-up radiography if available to identify the possible cause of failure
Results: The mean leg length discrepancy was 11 mm seen in four patients. Complications occurred in 4 patients (18%). One patient had early wound infection which cured completely after debridement, suction-irrigation and 6 weeks of intravenous antibiotics. One patient had incomplete sciatic nerve lesion which recovered completely at one year follow-up. Two patients had persistent groin pain. We had no loosening at last follow-up. Also neither instability nor mortality was reported.
Conclusion: Conversion of painful hemiarthroplasty gives good results with regard to the pain relief and functional scores