W Schneiders1, A Hartmann, T Meyner, K-P Günther. 1. UniversitätsCentrum für Orthopädie & Unfallchirurgie, Universitätsklinikum Dresden, Fetscherstraße 74, 01307, Dresden, Deutschland, wolfgang.schneiders@uniklinikum-dresden.de.
Abstract
BACKGROUND: The incidence of post-traumatic osteoarthritis after acetabular fractures is between 26 and 57%. With total hip arthroplasty (THA), affected patients can achieve a clear functional improvement and pain reduction if specific conditions are heeded. OBJECTIVE: Depending on the degree and localisation of bone defects and deformities, scarring and the presence of remaining osteosynthesis material, different treatment strategies are available. This review gives an overview of current treatment strategies. MATERIALS AND METHODS: Review of relevant clinical studies, meta-analyses and presentation of our own approach. RESULTS: The best results regarding to implant survival and clinical outcome, comparable with THA in primary osteoarthritis, can be achieved, when cementless acetabular reconstruction with anatomical restoration of the hip's rotational center and sufficient mechanical support is obtained. Pre-operative planing based on a thorough radiographic examination is essential. CONCLUSION: Althoug the postoperative complication rate is elevated after THA for posttraumatic arthritis after acetabular fractures compared with primary osteoarthritis, the overall functional results and implant survival are comparable.
BACKGROUND: The incidence of post-traumatic osteoarthritis after acetabular fractures is between 26 and 57%. With total hip arthroplasty (THA), affected patients can achieve a clear functional improvement and pain reduction if specific conditions are heeded. OBJECTIVE: Depending on the degree and localisation of bone defects and deformities, scarring and the presence of remaining osteosynthesis material, different treatment strategies are available. This review gives an overview of current treatment strategies. MATERIALS AND METHODS: Review of relevant clinical studies, meta-analyses and presentation of our own approach. RESULTS: The best results regarding to implant survival and clinical outcome, comparable with THA in primary osteoarthritis, can be achieved, when cementless acetabular reconstruction with anatomical restoration of the hip's rotational center and sufficient mechanical support is obtained. Pre-operative planing based on a thorough radiographic examination is essential. CONCLUSION: Althoug the postoperative complication rate is elevated after THA for posttraumatic arthritis after acetabular fractures compared with primary osteoarthritis, the overall functional results and implant survival are comparable.
Authors: C Bellabarba; R A Berger; C D Bentley; L R Quigley; J J Jacobs; A G Rosenberg; M B Sheinkop; J O Galante Journal: J Bone Joint Surg Am Date: 2001-06 Impact factor: 5.284