Skip to main content

Outcomes of Treatment Options for Acetabular Fractures in Older Patients

  • Chapter
  • First Online:
Acetabular Fractures in Older Patients
  • 378 Accesses

Abstract

Four treatments for geriatric acetabular fractures have been described in the literature to date: nonoperative, percutaneous fixation, open reduction and internal fixation (ORIF), and acute arthroplasty. Data on nonoperative treatment and percutaneous fixation are limited. There are more studies on ORIF and a fair number of small studies on acute arthroplasty. These studies do provide some guidance to clinicians and an excellent starting point for further work. However, the current literature is flawed by small sample size, retrospective methodology, and obvious selection bias that render comparison between techniques impossible. Future work is needed to address this obvious knowledge gap as clinicians currently have significant decisional uncertainty regarding the ideal treatment for any individual patient.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 79.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 99.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 139.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Anglen JO, Burd TA, Hendricks KJ, Harrison P. The “Gull sign”. A harbinger of failure for internal fixation of geriatric acetabular fractures. J Orthop Trauma. 2003;17(9):625–34.

    Article  Google Scholar 

  2. Béaule PE, Le Duff MJ, Dorey FJ, Amstutz HC. Fate of cementless acetabular components retained during revision total hip arthroplasty. J Bone Joint Surg Am. 2003;85-A(12):2288–93.

    Article  Google Scholar 

  3. Bellabarba C, Berger RA, Bentley CD, Quigley LR, et al. Cementless acetabular reconstruction after acetabular fracture. J Bone Joint Surg Am. 2001;83-A(6):868–76.

    Article  Google Scholar 

  4. Boardman KP, Charnley J. Low-friction arthroplasty after fracture-dislocations of the hip. J Bone Joint Surg Br. 1978;60-B(4):495–7.

    Article  CAS  Google Scholar 

  5. Boraiah S, Ragsdale MS, Achor T, Zelicof S, Asprinio DE. Open reduction internal fixation and primary total hip arthroplasty of selected acetabular fractures. J Orthop Trauma. 2009;23(4):243–8.

    Article  Google Scholar 

  6. Carroll EA, Huber FG, Goldman AT, Virkus WW, Pagenkopf E, Lorich DG, Helfet DL. Treatment of acetabular fractures in an older population. J Orthop Trauma. 2010;24(10):637–44.

    Article  Google Scholar 

  7. Chakravarty R, Toossi N, Katsman A, Cerynik DL, Harding SP, Johanson NA. Percutaneous column fixation and total hip arthroplasty for the treatment of acute acetabular fracture in the elderly. J Arthroplast. 2014;29(4):817–21.

    Article  Google Scholar 

  8. Enocson A, Blomfeldt R. Acetabular fractures in the elderly treated with a primary Burch-Schneider reinforcement ring, autologous bone graft, and a total hip arthroplasty: a prospective study with a 4-year follow-up. J Orthop Trauma. 2014;28(6):330–7.

    Article  Google Scholar 

  9. Gary JL, Lefaivre KA, Gerold F, Hay MT, Reinert CM, Starr AJ. Survivorship of the native hip joint after percutaneous repair of the acetabular fractures in the elderly. Injury. 2011;42(10):1144–51.

    Article  Google Scholar 

  10. Gary JL, VanHal M, Gibbons SD, Reinert CM, Starr AJ. Functional outcomes in elderly patients with acetabular fractures treated with minimally invasive reduction and percutaneous fixation. J Orthop Trauma. 2012;26(5):278–83.

    Article  Google Scholar 

  11. Gary JL, Paryavi E, Gibbons SD, Weaver MJ, et al. Effect of surgical treatment on mortality after acetabular fracture in the elderly: a multicenter study of 454 patients. J Orthop Trauma. 2015;29(4):202–8.

    Article  Google Scholar 

  12. Helfet DL, Borrelli JJ, DiPasquale T, Sanders R. Stabilization of acetabular fractures in elderly patients. J Bone Joint Surg Am. 1992;74(5):753–65.

    Article  CAS  Google Scholar 

  13. Herscovici D Jr, Lindvall E, Bolhofner B, Scaduto JM. The combined hip procedure: open reduction internal fixation combined with total hip arthroplasty for the management of acetabular fractures in the elderly. J Orthop Trauma. 2010;24(5):291–6.

    Article  Google Scholar 

  14. Jeffcoat DM, Carroll EA, Huber FG, Goldman AT, Miller AN, Lorich DG, Helfet DL. Operative treatment of acetabular fractures in an older population through a limited ilioinguinal approach. J Orthop Trauma. 2012;26(5):284–9.

    Article  Google Scholar 

  15. Johnson KA. Cementless total hip replacement complications. Vet Comp Orthop Traumatol. 2015;28(1):V–V1.

    Article  Google Scholar 

  16. Kim JW, Herbert B, Hao J, Min W, et al. Acetabular fractures in elderly patients: a comparative study of low-energy versus high-energy injuries. Int Orthop. 2015;39(6):1175–6.

    Article  Google Scholar 

  17. Letournel E. The treatment of acetabular fractures through the ilioinguinal approach. Clin Orthop Relat Res. 1993;292:62–76.

    Article  Google Scholar 

  18. Lin C, Caron J, Schmidt AH, Torchia M, Templeman D. Functional outcomes after total hip arthroplasty for the acute management of acetabular fractures: 1-to 14-year follow-up. J Orthop Trauma. 2015;29(3):151–9.

    Article  Google Scholar 

  19. Makridis KG, Obakponovwe O, Bobak P, Giannoudis PV. Total hip arthroplasty after acetabular fracture: incidence of complications, reoperation rates and functional outcomes: evidence today. J Arthroplast. 2014 Oct;29(10):1983–90.

    Article  Google Scholar 

  20. Malhotra R, Singh DP, Jain V, Kumar V, Singh R. Acute total hip arthroplasty in acetabular fractures in the elderly using the Octopus system: mid term to long term follow-up. J Arthroplasty. 2013;28(6):1005–9.

    Article  Google Scholar 

  21. Manson TT, Reider L, O’Toole RV, Scharfstein DO, et al. Variation in treatment of displaced geriatric acetabular fractures among 15 level-1 trauma centers. J Orthop Trauma. 2016;30(9):457–62.

    Article  Google Scholar 

  22. Matta JM. Fractures of the acetabulum: accuracy of reduction and clinical results in patients managed operatively within three weeks after the injury. J Bone Joint Surg Am. 1996;78(11):1632–45.

    Article  CAS  Google Scholar 

  23. Mears DC, Shirahama M. Stabilization of an acetabular fracture with cables for acute total hip arthroplasty. J Arthroplast. 1998;13(1):104–7.

    Article  CAS  Google Scholar 

  24. Mears DC, Velyvis JH. Acute total hip arthroplasty for selected displaced acetabular fractures: two to twelve-year results. J Bone Joint Surg Am. 2002;84-A:1):1–9.

    Google Scholar 

  25. Mouhsine E, Garofalo R, Borens O, Blanc CH, Wettstein M, Leyvraz PF. Cable fixation and early total hip arthroplasty in the treatment of acetabular fractures in elderly patients. J Arthroplast. 2004;19(3):344–8.

    Article  Google Scholar 

  26. O’Toole RV, Hui E, Chandra A, Nascone JW. How often does open reduction and internal fixation of geriatric acetabular fractures lead to hip arthroplasty? J Orthop Trauma. 2014;28(3):148–53.

    Article  Google Scholar 

  27. Pritchett JW, Bortel DT. Total hip replacement after central fracture dislocation of the acetabulum. Orthop Rev. 1991;20(7):607–10.

    CAS  PubMed  Google Scholar 

  28. Rickman M, Young J, Trompeter A, Pearce R, Hamilton M. Managing acetabular fractures in the elderly with fixation and primary arthroplasty: aiming for early weightbearing. Clin Orthop Relat Res. 2014;472(11):3375–82.

    Article  Google Scholar 

  29. Romness DW, Lewallen DG. Total hip arthroplasty after fracture of the acetabulum. Long-term results. J Bone Joint Surg Br. 1990;72(5):761–4.

    Article  CAS  Google Scholar 

  30. Ryan SP, Manson TT, Sciadini MF, Nascone JW, et al. Functional outcomes of elderly patients with nonoperatively treated acetabular fractures that meet operative criteria. J Orthop Trauma. 2017;31(12):644–9.

    Article  Google Scholar 

  31. Sermon A, Broos P, Vanderschot P. Total hip replacement for acetabular fractures. Results in 121 patients operated on between 1983 and 2003. Injury. 2008;39(8):914–21.

    Article  CAS  Google Scholar 

  32. Spencer RF. Acetabular fractures in older patients. J Bone Joint Surg Br. 1989;71(5):774–6.

    Article  CAS  Google Scholar 

  33. Starr AJ, Jones AL, Reinert CM, Borer DS. Preliminary results and complications following limited open reduction and percutaneous screw fixation of displaced fractures of the acetabulum. Injury. 2001;32(Suppl 1):SA45–50.

    Article  Google Scholar 

  34. Starr AJ, Watson JT, Reinert CM, Jones AL, et al. Complications following the “T extensile” approach: a modified extensile approach for acetabular fracture surgery-report of forty-three patients. J Orthop Trauma. 2002;16(8):535–42.

    Article  Google Scholar 

  35. Tidermark J, Blomfeldt R, Ponzer S, Söderqvist A, Tömkvist H. Primary total hip arthroplasty with a Burch-Schneider antiprotrusion cage and autologous bone grafting for acetabular fractures in elderly patients. J Orthop Trauma. 2003;17(3):193–7.

    Article  Google Scholar 

  36. Weber M, Berry DJ, Harnsen WS. Total hip arthroplasty after operative treatment of an acetabular fracture. J Bone Joint Surg Am. 1998;80(9):1295–305.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Robert V. O’Toole .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2020 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

O’Toole, R.V. (2020). Outcomes of Treatment Options for Acetabular Fractures in Older Patients. In: Manson, T. (eds) Acetabular Fractures in Older Patients. Springer, Cham. https://doi.org/10.1007/978-3-030-25105-5_10

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-25105-5_10

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-25104-8

  • Online ISBN: 978-3-030-25105-5

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics