{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T20:11:32Z","timestamp":1789675892261,"version":"4.0.1"},"reference-count":17,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T00:00:00Z","timestamp":1789430400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["HIP International"],"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Conversion of hip arthrodesis to total hip arthroplasty (THA) is technically demanding because of altered anatomy, soft-tissue contractures, and long-standing biomechanical adaptations. Preoperative complexity varies widely, and contemporary data on functional recovery and complications remain limited. This study evaluates functional and radiographic outcomes after conversion THA and introduces a Fusion-to-THA Surgical Complexity Score (FTCS) to characterise preoperative difficulty and explore its association with perioperative outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients and methods:<\/jats:title>\n                    <jats:p>We retrospectively reviewed 23 consecutive patients (16 males, 7 females; mean age 52\u2009\u00b1\u200912\u2009years) who underwent conversion THA between 2014 and 2020, after a mean fusion duration of 22\u2009\u00b1\u20097\u2009years. All procedures were performed through a posterior approach using cementless dual-mobility acetabular components and individualised femoral fixation. The FTCS incorporated fusion duration, soft-tissue contractures, retained hardware, leg-length discrepancy, abductor status, and acetabular distortion. Outcomes included Harris Hip Score (HHS), hip range of motion, gait, leg-length discrepancy, knee pain, and radiographic assessment using Engh and DeLee-Charnley criteria. Correlations between FTCS and perioperative parameters were analysed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      At a mean follow-up of 6.2\u2009years, HHS improved from 42\u2009\u00b1\u20098 to 82\u2009\u00b1\u200910 (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Mean hip flexion reached 85\u00b0\u2009\u00b1\u200915\u00b0, gait normalised in 20 patients, and leg-length discrepancy was corrected in 21. Knee pain decreased significantly and correlated with leg-length correction (r\u2009=\u20090.52,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.004). Higher FTCS values were associated with longer operative time and increased blood loss, representing exploratory associations within this cohort. Radiographs showed stable fixation and reliable osteointegration (mean Engh score 7.8\u2009\u00b1\u20091.2). 1 femoral stem revision and minor complications occurred, with no infections or permanent nerve injuries.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Conversion THA after hip arthrodesis yields substantial functional recovery and durable mid-term implant stability. The FTCS represents an exploratory descriptive framework to characterise preoperative complexity; however, its clinical applicability requires further validation in larger cohorts.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/11207000261474451","type":"journal-article","created":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T04:42:36Z","timestamp":1789533756000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Total hip arthroplasty after hip arthrodesis: functional outcomes, and mid-term survivorship integrating the fusion technique complexity score"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5700-493X","authenticated-orcid":false,"given":"Mahmoud","family":"Fahmy","sequence":"first","affiliation":[{"name":"Orthopaedic Department, Cairo University Kasr Alainy Faculty of Medicine, Cairo, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed","family":"Abo-Elsoud","sequence":"additional","affiliation":[{"name":"Orthopaedic Department, Cairo University Kasr Alainy Faculty of Medicine, Cairo, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3925-6607","authenticated-orcid":false,"given":"Mostafa Ahmed","family":"Shawky","sequence":"additional","affiliation":[{"name":"Orthopaedic Department, Cairo University Kasr Alainy Faculty of Medicine, Cairo, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,9,15]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00264-017-3436-z"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2010.02.005"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2013.01.025"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00402-016-2597-3"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00264-018-3762-9"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2020.09.030"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1097\/MS9.0000000000002024"},{"key":"e_1_3_2_9_2","first-page":"77","article-title":"Conversion of hip fusion to total hip arthroplasty","volume":"5","author":"Yousri AM","year":"2020","unstructured":"Yousri AM, Shoulah SA, Singer MS, et al. Conversion of hip fusion to total hip arthroplasty. Benha J Appl Sci 2020; 5: 77\u201382.","journal-title":"Benha J Appl Sci"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.5435\/00124635-201112000-00004"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11420-013-9330-3"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1097\/00003086-200002000-00017"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-200208000-00008"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.5301\/hipint.5000256"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.artd.2020.09.020"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.103B7.BJJ-2020-2382.R1"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00590-023-03695-8"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2023.07.021"}],"container-title":["HIP International"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/11207000261474451","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/11207000261474451","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/11207000261474451","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T19:48:17Z","timestamp":1789674497000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/11207000261474451"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,15]]},"references-count":17,"alternative-id":["10.1177\/11207000261474451"],"URL":"https:\/\/doi.org\/10.1177\/11207000261474451","relation":{},"ISSN":["1120-7000","1724-6067"],"issn-type":[{"value":"1120-7000","type":"print"},{"value":"1724-6067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,15]]},"article-number":"11207000261474451"}}