Simultaneous open reduction and internal fixation and total hip arthroplasty for the treatment of osteoporotic acetabular fractures

Salama, Wael; Mousa, Shazly; Khalefa, Abdelrahman; Sleem, Ahmed; Kenawey, Mohamed; Ravera, Laura; Massè, Alessandro

doi:10.1007/s00264-016-3175-6

Cited by 45 publications

(30 citation statements)

References 28 publications

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“…We obtained the full-text of all potentially relevant reports and two review authors (EL, HP) independently screened all full-text reports for inclusion and exclusion criteria. Twenty-five articles were excluded after full text review for the following reasons: seven non-English language articles, 10 , 11 , 12 , 13 , 14 , 15 , 16 eight articles describing acute fracture management or lacking delayed THA, 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 eight articles with insufficient sample size (case reports and review articles), 5 , 6 , 25 , 26 , 27 , 28 , 29 , 30 one article with insufficient outcome data or follow-up duration, 31 and one article with co-occurring femur fractures and other ipsilateral injuries. 32 Cases of disagreement were resolved by discussion, and if no consensus was reached a third review author (SN) was consulted to make the decision.…”

Section: Methodsmentioning

confidence: 99%

Total hip arthroplasty for posttraumatic osteoarthritis following acetabular fracture: A systematic review of characteristics, outcomes, and complications

Stibolt

Patel

Huntley

et al. 2018

Chinese Journal of Traumatology

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PurposePosttraumatic arthritis (PTA) may develop years after acetabular fracture, hindering joint function and causing significant chronic musculoskeletal pain. Given the delayed onset of PTA, few studies have assessed outcomes of delayed total hip arthroplasty (THA) in acetabular fracture patients. This study systematically reviewed the literature for outcomes of THA in patients with PTA and prior acetabular fracture.MethodsPubmed, EMBASE, SCOPUS, and Cochrane library were searched for articles containing the keywords “acetabular”, “fracture”, “arthroplasty”, and “post traumatic arthritis” published between 1995 and August 2017. Studies with less than 10 patients, less than 2 years of follow-up, conference abstracts, and non-English language articles were excluded. Data on patient demographics, surgical characteristics, and outcomes of delayed THA, including implant survival, complications, need for revision, and functional scores, was collected from eligible studies.ResultsWith 1830 studies were screened and data from 10 studies with 448 patients were included in this review. The median patient age on date of THA was 51.5 years, ranging from 19 to 90 years. The median time from fracture to THA was 37 months, with a range of 27–74 months. Mean follow-up times ranged from 4 to 20 years. The mean Harris hip scores (HHS) improved from 41.5 pre-operatively, to 87.6 post-operatively. The most prevalent postoperative complications were heterotopic ossification (28%–63%), implant loosening (1%–24%), and infection (0%–16%). The minimum 5-year survival of implants ranged from 70% to 100%. Revision rates ranged from 2% to 32%.ConclusionDespite the difficulties associated with performing THA in patients with PTA from previous acetabular fracture (including soft tissue scarring, existing hardware, and acetabular bone loss) and the relatively high complication rates, THA in patients with PTA following prior acetabular fracture leads to significant improvement in pain and function at 10-year follow-up. Further high quality randomized controlled studies are needed to confirm the outcomes after delayed THA in these patients.

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Section: Methodsmentioning

confidence: 99%

Total hip arthroplasty for posttraumatic osteoarthritis following acetabular fracture: A systematic review of characteristics, outcomes, and complications

Stibolt

Patel

Huntley

et al. 2018

Chinese Journal of Traumatology

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“…When considering a delay between a fracture and THA in the elderly, some authors agree that an acute surgery within 21 days after fracture is best, whereas others conclude that surgery should be delayed so that the fractured bones have time to heal. In elderly patients with severely displaced acetabular fractures with non-anatomical bone alignment or severe pain, early THA is an alternative way to achieve a painless and stable hip [6] , [7] . Functional treatment is recommended for 2 weeks, using light traction or immediate mobilization, so the fragments can mold themselves around the head [17] .…”

Section: Discussionmentioning

confidence: 99%

“…Diagnosis of these injuries and particularly acetabular fracture is often delayed due to a lack of clinical suspicion and appropriate investigation [1] , [4] . Once recognized, recovery options include treatments with limited weight-bearing for 6 weeks or more (closed management, open reduction with internal fixation, percutaneous fixation in situ), and those with immediate weight-bearing (acute or staged total hip arthroplasty [THA]) [5] , [6] , [7] . In patients over 60 years of age, acetabular fracture treatment remains challenging because of precarious general health, severe osteopenia, comminution, and associated femoral head damage [8] .…”

Section: Introductionmentioning

confidence: 99%

Early simultaneous bilateral total hip arthroplasty for the management of bilateral acetabular fracture in an elderly patient

2019

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Bilateral acetabular fractures in elderly patients due to seizures are very rare and management is a challenge. The standard treatment for acetabular fracture, open reduction with internal fixation, is not recommended for the elderly because of poor bone quality and the need for bed rest. In the acute phase, total hip arthroplasty may be the best treatment option because it allows early mobilization and avoids bed rest complications. We report the case of a 76-year-old man with a bilateral comminuted acetabular fractures and a left fracture dislocation of the shoulder, treated by immediate shoulder arthroplasty and a one-stage bilateral total hip arthroplasty procedure at 3 weeks, with a good result at 1-year follow-up.

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“…Nowadays, with modern protrusion cages, the semielliptical cups, the mobility and the new double-coated hydroxyapatite femoral stems, the implant failure is very difficult, if not rare. Moreover, this implant can have a long life as a primary THA osteoarthritis implant [22][23][24][25][26][27]. In the literature, it is shown that the prosthesis in acetabular fracture outcomes has a higher bleeding compared to THA and ORIF in acute trauma [1,28].…”

Section: Discussionmentioning

confidence: 99%

Total hip arthroplasty vs. osteosynthesis in acute complex acetabular fractures in the elderly: Evaluation of surgical management and outcomes

Carta

Falzarano

Rollo

et al. 2016

JAD

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Objective: To retrospectively evaluate the open reduction internal fixation and total hip arthroplasty directions, results and complications associated with internal fixation in managing these fractures. Methods: In 8 years at 4 centers, 61 patients with associated acetabular fractures (Letournel classification) were treated. The patients were divided into two groups. The total hip arthoplasty (THA) group consisted of 30 patients, while the open reduction internal fixation group had 31 patients. The average age of the patients was 74.7 years. The following parameters were compared: the duration of surgery and hospitalization, the international unit of red blood cell concentrate transfusion, the time for the verticalization of the patient, perioperative complications, Harris hip score, and the short form (12) health survey. The clinical and radiographic follow-up was performed at 1 month, 3 months, 6 months and 12 months and annually thereafter. Patients with post-traumatic osteoarthritis formed the third comparison group. P ≤ 0.05 was considered statistically significant according to the analytical Student's t-test. Results: The P < 0.05 in favor of the THA group was: surgical time, length of stay, number of the international unit of red blood cell concentrate transfusions, verticalization, quality of life and hip function, a reduction of perioperative complications and reinterventions. Conclusions: Our experience shows that the THA treatment for acetabular fractures in the elderly is to be preferred.

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Simultaneous open reduction and internal fixation and total hip arthroplasty for the treatment of osteoporotic acetabular fractures

Abstract: ORIF and simultaneous THR is a good option for the treatment of certain types of acetabular fractures particularly in elderly population.

Cited by 45 publications

References 28 publications

Total hip arthroplasty for posttraumatic osteoarthritis following acetabular fracture: A systematic review of characteristics, outcomes, and complications

Total hip arthroplasty for posttraumatic osteoarthritis following acetabular fracture: A systematic review of characteristics, outcomes, and complications

Early simultaneous bilateral total hip arthroplasty for the management of bilateral acetabular fracture in an elderly patient

Total hip arthroplasty vs. osteosynthesis in acute complex acetabular fractures in the elderly: Evaluation of surgical management and outcomes

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