Total hip replacement after central fracture dislocation of the acetabulum.

We performed total hip replacement (THR) for traumatic arthritis following central fracture dislocation of the acetabulum in 19 patients (15 men and four women). This situation is significantly challenging, as most patients have scarring, contractures, and unequal leg length. The average age was 49 years, and all patients were followed for a minimum of 2 years. A two-piece cementless acetabular component and a cemented or cementless femoral component were utilized. In each patient, prophylactic low-dose irradiation was administered to discourage heterotopic ossification, and gentamicin with either cefazolin or vancomycin were given as prophylaxis for infection. Overall, the results were excellent. The mean Harris hip score after surgery was 84. No infections, dislocations, or significant heterotopic ossification occurred. Limb length was within 1 cm in each patient. No revision surgeries were performed, and no components were roentgenographically loose. There was one case of transient nerve palsy. We conclude that THR after central fracture dislocation of the acetabulum is a safe and effective procedure.