Aaditya Manirajan1, Henry Seidel2, Miguel Daccarett3, Daryl Dillman3, Lewis Shi3, Jason Strelzow3. 1. The University of Chicago Pritzker School of Medicine, Chicago, IL, 60637, USA. Aaditya.manirajan@uchospitals.edu. 2. The University of Chicago Pritzker School of Medicine, Chicago, IL, 60637, USA. 3. Department of Orthopaedics, The University of Chicago Medicine, Chicago, IL, 60637, USA.
Abstract
PURPOSE: This study evaluates complication rates following treatment modalities of THA for acetabular fractures in the older population. METHODS: A national insurance database was used to identify acetabular fracture patients of age > 50 who underwent THA treatment within two years of fracture. Four subgroups were identified: primary THA < 2 months after injury (acute THA), primary THA > 2 months after injury (delayed THA), simultaneous ORIF and THA, and conversion THA after ORIF (THA after ORIF). A 3:1 match was performed between these subgroups and patients undergoing THA for non-fracture causes. Patients were matched based on age, gender and the diagnosis of diabetes, hypertension, obesity or tobacco use. Complication rates were compared, including hospital readmission, revision, infection and deep vein thrombosis (DVT). RESULTS: In total, 3807 patients met inclusion criteria and were matched with 11,421 controls. Compared to controls, acute THA and delayed THA patients had significantly increased rates of all complications (OR ranges 1.45 - 2.82, p < 0.001). Simultaneous ORIF and THA and THA after ORIF patients had significantly increased rates of revision, infection and DVT (OR ranges 1.76 - 3.96, p ranges < 0.001 - p = 0.031). Compared to delayed THA, acute THA patients had significantly higher rates of readmission (OR = 1.16, p = 0.021) and DVT (OR = 1.89, p < 0.001). CONCLUSION: Consistent with prior literature, THA after acetabular fracture is associated with higher complication rates than THA for non-fracture causes. Acute THA following acetabular fracture is also associated with higher rates of readmission and DVT than delayed THA.
PURPOSE: This study evaluates complication rates following treatment modalities of THA for acetabular fractures in the older population. METHODS: A national insurance database was used to identify acetabular fracture patients of age > 50 who underwent THA treatment within two years of fracture. Four subgroups were identified: primary THA < 2 months after injury (acute THA), primary THA > 2 months after injury (delayed THA), simultaneous ORIF and THA, and conversion THA after ORIF (THA after ORIF). A 3:1 match was performed between these subgroups and patients undergoing THA for non-fracture causes. Patients were matched based on age, gender and the diagnosis of diabetes, hypertension, obesity or tobacco use. Complication rates were compared, including hospital readmission, revision, infection and deep vein thrombosis (DVT). RESULTS: In total, 3807 patients met inclusion criteria and were matched with 11,421 controls. Compared to controls, acute THA and delayed THA patients had significantly increased rates of all complications (OR ranges 1.45 - 2.82, p < 0.001). Simultaneous ORIF and THA and THA after ORIF patients had significantly increased rates of revision, infection and DVT (OR ranges 1.76 - 3.96, p ranges < 0.001 - p = 0.031). Compared to delayed THA, acute THA patients had significantly higher rates of readmission (OR = 1.16, p = 0.021) and DVT (OR = 1.89, p < 0.001). CONCLUSION: Consistent with prior literature, THA after acetabular fracture is associated with higher complication rates than THA for non-fracture causes. Acute THA following acetabular fracture is also associated with higher rates of readmission and DVT than delayed THA.
Authors: Patrick D G Henry; Sam Si-Hyeong Park; J Michael Paterson; Hans J Kreder; Richard Jenkinson; David Wasserstein Journal: J Orthop Trauma Date: 2018-03 Impact factor: 2.512
Authors: Zachary Morison; Dirk Jan F Moojen; Aaron Nauth; Jeremy Hall; Michael D McKee; James P Waddell; Emil H Schemitsch Journal: Clin Orthop Relat Res Date: 2016-02 Impact factor: 4.176
Authors: Katharine Hamlin; Gabija Lazaraviciute; Michalis Koullouros; Tarak Chouari; Iain M Stevenson; Steven W Hamilton Journal: Indian J Orthop Date: 2017 Jul-Aug Impact factor: 1.251