In a retrospective study, we examined twenty-eight patients who had had
an arthrodesis seventeen to fifty years previously (average, thirty-five
years). Hip and knee ratings were obtained, as well as anteroposterior and
flexion-extension radiographs of the lumbar spine and standing
anteroposterior radiographs of the knees and hips. About 60 per cent of the
patients had pain in the ipsilateral knee (average time to onset,
twenty-three years after arthrodesis), and a similar percentage had back
pain (average time to onset, twenty-five years after the operation). Pain
in the contralateral hip occurred in approximately 25 per cent of the
patients (average time to onset, twenty years after arthrodesis). Only one
patient was unemployed due to disabling pain in the back or knee. Seventy
per cent of the patients could walk more than one mile (1.6 kilometers),
and a similar percentage could sit comfortably for at least two hours.
Seventy-five per cent of the patients had anteroposterior laxity of the
ipsilateral knee, and 80 per cent had mediolateral laxity. The patients
whose hip was fused in some abduction more frequently had pain in the
ipsilateral knee and the back, and they had greater degenerative changes in
the ipsilateral knee than the patients whose hip was fused in adduction or
in the neutral position. Six patients had undergone total hip arthroplasty
for pain in the back or the ipsilateral knee, or both, and all had marked
relief of back pain, while two of four had relief of pain in the knee. Two
patients had a total knee arthroplasty for relief of pain in the
ipsilateral knee.