Acetabular Outcome after Hip Hemiarthroplasty in Patients with Tumors

Hip hemiarthroplasty is performed routinely on patients with tumors of the proximal femur, although the long-term effect on the native acetabulum is unknown. We measured the amount of femoral head migration that would occur with intermediate and long-term followup. We also measured the amount of groin pain experienced by patients with longer followup and the overall rate of conversion to total hip arthroplasty. From a surgical database, we identified 442 patients with tumors who had 447 hip hemiarthroplasties without or with an allograft composite. We reviewed the medical records and radiographs of 32 patients with at least 5 years followup (median followup, 10 years) to determine their clinical and radiographic outcomes. The median proximal and medial migration measurements were 3 mm (range, 0-24 mm) and 2 mm (range 0-20 mm), respectively. Thirty-one patients had minimal or no groin pain. Seven of the 447 arthroplasties (1.6%) were converted to total hip arthroplasties. Even patients with long-term followup usually had minimal pain and radiographic changes. The overall rate of conversion to total hip arthroplasty was low. Concern regarding excessive acetabular wear resulting in conversion to total hip arthroplasty in patients with tumors is not supported by our data.

Level of Evidence: Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.