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Total hip arthroplasty following acetabular fracture: a clinical and radiographic outcome analysis of 67 patients

  • Trauma Surgery
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Abstract

Background

Total hip arthroplasty (THA) is a challenging option for the treatment of posttraumatic arthritis due to acetabular fractures.

Methods

The study aimed to determine the short- and mid-term clinical and radiographic results of THA following acetabular fracture. The fracture pattern, the extent of injury and the initial fracture treatment were considered to evaluate the influence of these factors on the clinical-radiographic outcome.

Results

67 patients who received THA for the treatment of posttraumatic osteoarthritis after acetabular fracture between January 2007 and December 2012 were analyzed consecutively. The group consisted of 13 female (19%) and 54 male (81%) patients with a mean age of 59 (25–87) years at the time of THA. The time between acetabular injury and arthroplasty was 107 (1–504) months on average. The all-cause 8-year survival rate was 0.87% (0.76–0.93) and there were 8 revisions, half of them were due to aseptic loosening of the cup. The Harris Hip Score achieved was 75.7 ± 21.3 (26.9–100) points. Prior to THA, heterotopic ossifications were detected in 28% and after THA implantation in 42%.

Conclusion

The decrease of the interval between injury and arthroplasty was associated with increasing patient age (p = 0.001) and surgical treatment of the acetabular fracture (p = 0.04). Complex fracture patterns were accompanied by acetabular bone defects more often than simple patterns (p = 0.03). Overall, arthroplasty due to posttraumatic osteoarthritis after acetabular fracture resulted in decreased overall survival rates and poorer clinical outcome as compared to primary arthroplasty.

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Data availability

All patient-related data were collected by file research from the archives of the Department of Orthopaedics and Trauma Surgery, BG Trauma Center Tübingen, Germany.

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Authors and Affiliations

  1. Department of Orthopaedics and Trauma Surgery, University of Duisburg-Essen, Hufelandstr. 55, 45147, Essen, Germany

    André Busch

  2. BG Trauma Center Tübingen, Eberhard Karls University of Tübingen, Schnarrenbergstr. 95, Tübingen, Germany

    André Busch, Ulrich Stöckle, Anna Schreiner, Peter de Zwaart, Aljoscha Schäffler & Björn Gunnar Ochs

  3. Krankenhaus Freudenstadt, Karl-von-Hahn-Straße 120, 72250, Freudenstadt, Germany

    Aljoscha Schäffler

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Busch, A., Stöckle, U., Schreiner, A. et al. Total hip arthroplasty following acetabular fracture: a clinical and radiographic outcome analysis of 67 patients. Arch Orthop Trauma Surg 140, 331–341 (2020). https://doi.org/10.1007/s00402-019-03272-x

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