Evidence map›Paper›PMID 41786672›Full record

ReviewHip international : the journal of clinical and experimental research on hip pathology and therapy2026

Conversion total hip arthroplasty following failed proximal femoral fixation: current concepts review.

Amaan A Merchant, Elliot Onochie, Babar Kayani, James Donaldson, John G Stammers, John A Skinner

Abstract readReview
In one paragraph

Review in Hip international : the journal of clinical and experimental research on hip pathology and therapy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Amaan A MerchantUniversity College London - UCLMS, London, UK.ORCID 0009-0006-7093-8055
Elliot OnochieRoyal National Orthopaedic Hospital, Stanmore, UK.
Babar KayaniRoyal National Orthopaedic Hospital, Stanmore, UK.
James DonaldsonRoyal National Orthopaedic Hospital, Stanmore, UK.
John G StammersTrauma and Orthopaedics, St George's Hospital NHS Foundation Trust, London, UK.
John A SkinnerUniversity College London - UCLMS, London, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionFailed internal fixation of proximal femoral fractures is associated with significant morbidity, mortality, and financial burden. Conversion total hip arthroplasty (THA) is a technically demanding salvage procedure associated with high risks of periprosthetic joint infection and instability.

methodsIndependent searches of MEDLINE, EMBASE, and the Cochrane library were performed for studies published from 1990 onwards regarding conversion THA in adults following failed proximal femur fixation. Following screening, 34 studies were included in this review.

resultsPredictors of failure include female sex, smoking, and tip-apex distance >25 mm. Preoperative screening for occult, extra-articular infection is vital, as pathogens often reside near hardware rather than within the joint. CT, ultrasound, and SPECT-CT are essential for assessing bone stock and identifying fluid collections. Dual-mobility cups effectively reduce dislocation rates to 0-3%. Functional scores improve significantly, though 10-year survivorship is approximately 86%. DISCUSSION: Conversion THA provides substantial functional recovery but carries a 7-fold higher infection risk than primary THA. Success requires meticulous screening tailored to previous hardware sites and selecting femoral fixation based on bone quality and cortical defects. Specialised implants are essential for optimising long-term outcomes in this high-risk population.

Indexed as

Arthroplasty, Replacement, HipFracture Fixation, InternalProximal Femoral FracturesFemaleHumansProsthesis FailureReoperationRisk AssessmentTreatment FailureComplicationsinternal fixationoutcomesproximal femur fracturesurvivorshiptotal hip arthroplasty

Identifiers

PMID41786672
PMCPMC13379609

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.