Konigsberg*, Nordin, Lackner, Hartman and Garvin
University of Nebraska Medical Center, Nebraska Medical Center, USA
*Corresponding Author: Konigsberg, University of Nebraska Medical Center, Nebraska Medical Center, USA.
Received: December 31, 2021; Published: January 25, 2022
Background: Acetabulum fractures can lead to post-traumatic arthritis necessitating total hip arthroplasty (THA). Some studies have shown higher rates of failure in patients undergoing THA after acetabular fracture as compared to primary THA. Likewise, studies have shown uncemented acetabular fixation has shown improved outcomes in primary THA.
Study Objective: This study evaluates outcomes of uncemented acetabular fixation in THA for post-traumatic arthritis following an acetabular fracture. Furthermore, there are comparisons of outcomes between highly cross-linked polyethylene (HXLPE) with conventional polyethylene as well as evaluation of outcomes utilizing different femoral head components.
Methods: 78 total hip arthroplasties (77 patients) for post-traumatic arthritis after acetabulum fracture were performed at our institution from 1991-2015. Routine follow-up was performed (range 6 weeks to 23 years). After institutional review board approval, patients were asked to return for clinical and radiographic evaluation. Patients who were unable to return to clinic were contacted by mail and telephone. At the time of this study, twenty-three patients were known to have died. Fifty-eight patients (59 hips) had a minimum of 2 year follow up available.
Results: Of the 78 arthroplasties performed, 8 (10.2%) underwent revision surgery (3 for instability, 1 for loosening, 1 for wear and trunnionosis, 1 for femoral fracture, 1 for infection, and 1 for persistent pain).
Of the 58 patients with a minimum of 2-year follow-up available, the mean follow-up period was 10.2 years (2-25). 6 of the 59 (10.2%) arthroplasties has been revised. The mean Harris Hip Score was 79.6 (33-100). There were 50 HXLPE liners, 8 conventional polyethylene and 1 ceramic liner. These showed no clinical or radiographic difference at any follow up period. There was 1 revision for polyethylene wear at 16 years postoperatively in a patient with a conventional liner.
Conclusion: The intermediate term results of a relatively large group of patients who underwent cementless THA for post-traumatic arthritis following acetabular fracture at a single institution over a 24-year period yielded satisfactory outcomes with revision rates comparable or better to other similar studies. Additionally, there were no differences in revision rates seen with conventional polyethylene vs HXPLE. Femoral head implant bearing surface also did not have an observable difference in outcomes.
Keywords: Acetabulum Fracture; Hip Arthroplasties; Posttraumatic Arthritis
Citation: Konigsberg., et al. “Intermediate Term Results of Total Hip Arthroplasty with Uncemented Acetabular Components for Patients with a Prior Acetabular Fracture".Acta Scientific Orthopaedics 5.2 (2022): 20-24.
Copyright: © 2022 Konigsberg., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.