Short-term results of total hip replacement due to acetabular fractures
István Flóris, Tamás Bodzay, Zsolt Vendégh, Balázs Gloviczki, Péter Balázs
Péterfy Hospital and Trauma Centre, Budapest, Hungary
Keywords: Acetabular fracture; arthroplasty; necrosis of the femoral head; secondary post-traumatic osteoarthritis.
Objectives: This study aims to evaluate short-term results of total hip replacement performed for post-traumatic osteoarthritis and/or femoral head necrosis caused by acetabular fractures.
Patients and methods: We performed 39 arthroplasties due to acetabular fractures on 25 male and 14 female patients during the course of a five-year period. The mean age of the patients was 45 years (range 25 to 73 years) at the time of surgery. Cemented cup was implanted in 29 patients and uncemented cup in 10 patients. Bone replacement was indicated in eight patients for different degrees of acetabular deformities. Implantation of an acetabular socket was indicated in six patients.
Results: The evaluation was based on the Harris hip score (HHS). The mean HHS score was 42 prior to arthroplasty and 81 after arthroplasty. Repeated surgery was required for infection in two patients. Dislocation of the prosthesis occurred in three patients, deep venous thrombosis in one patient and the lesion of the sciatic nerve in one patient after surgery.
Conclusion: Our study results suggest that the selection of the cup type depends on the condition and bone deformity secondary to acetabular fracture. Surgical interventions are technically more difficult, and take longer with a high rate of the postoperative complications and prolonged rehabilitation period, compared to arthroplasties for degenerative hip diseases.