Eduardo García-Rey1, Rossella Sirianni2, Eduardo García-Cimbrelo1, Laurent Sedel3,4. 1. Orthopaedic Surgery Department, Hospital La Paz-IdiPaz, Madrid, Spain. 2. Orthopaedic Surgery Department, Versilia Hospital, Lido di Camaiore-Lucca, Italy. 3. Emeritus University of Paris Diderot, Paris, France. 4. Clinique Saint Jean de Dieu, Paris, France.
Abstract
PURPOSE: To determine if initial treatment affects the outcome of total hip arthroplasty (THA) after acetabular fracture. METHODS: 49 patients (49 hips) initially treated non-operatively followed some months later by THA in conjunction with acetabular reconstruction (Group 1) and 29 patients (29 hips) who had undergone THA after a previous osteosynthesis (Group 2) were assessed. The mean follow-up was 11.7 (range 5-23) years. RESULTS: 3 acetabular components were revised for aseptic loosening in Group 1 and 2 in Group 2. The survival rate for cup loosening at 16 years was 90.6% (95% confidence interval [CI], 78.1-100) for Group 1 and 94.1% (95% CI, 86.5-100) for Group 2 (p = 0.76). There were 2 sciatic palsies in Group 2 after osteosynthesis. The mean preoperative clinical score and postoperative range of mobility were better in Group 1. There were more heterotopic ossifications in Group 2. CONCLUSION: Despite the good results found in both groups, THA after previous osteosynthesis for acetabular fractures had more complications than a primary THA in conjunction with acetabular reconstruction.
PURPOSE: To determine if initial treatment affects the outcome of total hip arthroplasty (THA) after acetabular fracture. METHODS: 49 patients (49 hips) initially treated non-operatively followed some months later by THA in conjunction with acetabular reconstruction (Group 1) and 29 patients (29 hips) who had undergone THA after a previous osteosynthesis (Group 2) were assessed. The mean follow-up was 11.7 (range 5-23) years. RESULTS: 3 acetabular components were revised for aseptic loosening in Group 1 and 2 in Group 2. The survival rate for cup loosening at 16 years was 90.6% (95% confidence interval [CI], 78.1-100) for Group 1 and 94.1% (95% CI, 86.5-100) for Group 2 (p = 0.76). There were 2 sciatic palsies in Group 2 after osteosynthesis. The mean preoperative clinical score and postoperative range of mobility were better in Group 1. There were more heterotopic ossifications in Group 2. CONCLUSION: Despite the good results found in both groups, THA after previous osteosynthesis for acetabular fractures had more complications than a primary THA in conjunction with acetabular reconstruction.
Entities:
Keywords:
Acetabular fracture; clinical outcome; non-operative; previous osteosynthesis; radiological analysis; total hip arthroplasty; treatment