Outcomes of acute versus delayed total hip arthroplasty following acetabular fracture
Purpose Post-traumatic arthritis is known complication following acetabular fracture. The aim was to compare mid- to long-term outcomes of acute THA (aTHA) for acetabular fracture and delayed THA (dTHA) following failure of ORIF or conservative management. Methods We retrospectively analysed 60 THA...
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| Veröffentlicht in: | European journal of orthopaedic surgery & traumatology 2023-01, Vol.33 (1), p.51-60 |
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| container_title | European journal of orthopaedic surgery & traumatology |
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| creator | Gracia, G. Laumonerie, P. Tibbo, M. E. Cavaignac, E. Chiron, P. Reina, N. |
| description | Purpose
Post-traumatic arthritis is known complication following acetabular fracture. The aim was to compare mid- to long-term outcomes of acute THA (aTHA) for acetabular fracture and delayed THA (dTHA) following failure of ORIF or conservative management.
Methods
We retrospectively analysed 60 THA (21 aTHA; 39 dTHA) performed for acetabular fracture between 2004 and 2014 in 60 patients with a mean age of 59 years (20–94). Functional and Radiographic outcomes were assessed at a mean follow-up of 5 years (2–13) utilizing Oxford, Harris Hip (HHS), and Postel Merle d’Aubigné (PMA) scores and Brooker classification.
Results
The mean HHS (73), Oxford (32) and PMA (12) scores were significantly lower in the aTHA group. Acute THA was significantly associated with lower postoperative Oxford (
β
= −4.2), HHS (
β
= −7.8), and PMA (
β
= −2.2) scores at mean 5 years (2–13). Eleven patients returned to the operating room. There were no significant differences between THA performed in acute or delayed fashion. The two primary reasons for revision were periprosthetic joint infection (
n
= 5) and aseptic loosening (
n
= 4). Survivorship free from reoperation at 10 years was 91% and 82% for aTHA and dTHA, respectively (
p
= 0.24). Increased PMA scores were associated with decreased overall survival of the THA free from reoperation (HR = 0.60). The degree of heterotopic ossification was significantly higher in the aTHA group (
p |
| doi_str_mv | 10.1007/s00590-021-03157-z |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2590119071</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2590119071</sourcerecordid><originalsourceid>FETCH-LOGICAL-c375t-8b7eec930937dc80dd3741aa7b1217973ad58d5461a7891efbb112f951f784e43</originalsourceid><addsrcrecordid>eNp9kE1PGzEQhq2qqITAH-ihstQLl21n1ut4faxQC0hIuZCz5d2dTYKcOPijKPz6uoQWxIHTWJrnfcd6GPuM8A0B1PcIIDVUUGMFAqWqHj-wCTairhBm7cdX72N2EuMdAEqN8hM7Fo0qO40Ttpjn1PsNRe5HbvuciP-mEHPkAzm7p4Enn6zjq_WO25BWwe-cjWnPR--cf1hvlyVFyXbZ2cDHYPuUA52yo9G6SGfPc8oWv37eXlxVN_PL64sfN1UvlExV2ymiXgvQQg19C8MgVIPWqg5rVFoJO8h2kM0MrWo10th1iPWoJY6qbagRU3Z-6N0Ff58pJrNZx56cs1vyOZq6-EHUoLCgX9-gdz6HbfmdqdUMFMyk0oWqD1QffIyBRrML640Ne4Ng_ko3B-mmSDdP0s1jCX15rs7dhob_kX-WCyAOQCyr7ZLCy-13av8Au_WNXA</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2760706579</pqid></control><display><type>article</type><title>Outcomes of acute versus delayed total hip arthroplasty following acetabular fracture</title><source>MEDLINE</source><source>Springer Nature - Complete Springer Journals</source><creator>Gracia, G. ; Laumonerie, P. ; Tibbo, M. E. ; Cavaignac, E. ; Chiron, P. ; Reina, N.</creator><creatorcontrib>Gracia, G. ; Laumonerie, P. ; Tibbo, M. E. ; Cavaignac, E. ; Chiron, P. ; Reina, N.</creatorcontrib><description>Purpose
Post-traumatic arthritis is known complication following acetabular fracture. The aim was to compare mid- to long-term outcomes of acute THA (aTHA) for acetabular fracture and delayed THA (dTHA) following failure of ORIF or conservative management.
Methods
We retrospectively analysed 60 THA (21 aTHA; 39 dTHA) performed for acetabular fracture between 2004 and 2014 in 60 patients with a mean age of 59 years (20–94). Functional and Radiographic outcomes were assessed at a mean follow-up of 5 years (2–13) utilizing Oxford, Harris Hip (HHS), and Postel Merle d’Aubigné (PMA) scores and Brooker classification.
Results
The mean HHS (73), Oxford (32) and PMA (12) scores were significantly lower in the aTHA group. Acute THA was significantly associated with lower postoperative Oxford (
β
= −4.2), HHS (
β
= −7.8), and PMA (
β
= −2.2) scores at mean 5 years (2–13). Eleven patients returned to the operating room. There were no significant differences between THA performed in acute or delayed fashion. The two primary reasons for revision were periprosthetic joint infection (
n
= 5) and aseptic loosening (
n
= 4). Survivorship free from reoperation at 10 years was 91% and 82% for aTHA and dTHA, respectively (
p
= 0.24). Increased PMA scores were associated with decreased overall survival of the THA free from reoperation (HR = 0.60). The degree of heterotopic ossification was significantly higher in the aTHA group (
p
< 0.001).
Conclusion
Acute THA in the setting of acetabular fracture is a technically challenging procedure. However, in the present series, aTHA provided satisfactory immediate stability and good survivorship at 10 years in a medically vulnerable patient population.
Level of Evidence
Level 3; Therapeutic study.</description><identifier>ISSN: 1432-1068</identifier><identifier>ISSN: 1633-8065</identifier><identifier>EISSN: 1432-1068</identifier><identifier>DOI: 10.1007/s00590-021-03157-z</identifier><identifier>PMID: 34714391</identifier><language>eng</language><publisher>Paris: Springer Paris</publisher><subject>Acetabulum - diagnostic imaging ; Acetabulum - injuries ; Acetabulum - surgery ; Age ; Arthritis ; Arthroplasty, Replacement, Hip - adverse effects ; Arthroplasty, Replacement, Hip - methods ; Follow-Up Studies ; Fractures ; Hip Fractures - surgery ; Hip Prosthesis - adverse effects ; Humans ; Hypotheses ; Joint replacement surgery ; Medicine ; Medicine & Public Health ; Middle Aged ; Original Article ; Orthopedics ; Patients ; Prosthesis Failure ; Reoperation ; Retrospective Studies ; Spinal Fractures - surgery ; Surgical Orthopedics ; Traumatic Surgery ; Treatment Outcome</subject><ispartof>European journal of orthopaedic surgery & traumatology, 2023-01, Vol.33 (1), p.51-60</ispartof><rights>The Author(s), under exclusive licence to Springer-Verlag France SAS, part of Springer Nature 2021</rights><rights>2021. The Author(s), under exclusive licence to Springer-Verlag France SAS, part of Springer Nature.</rights><rights>The Author(s), under exclusive licence to Springer-Verlag France SAS, part of Springer Nature 2021.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c375t-8b7eec930937dc80dd3741aa7b1217973ad58d5461a7891efbb112f951f784e43</citedby><cites>FETCH-LOGICAL-c375t-8b7eec930937dc80dd3741aa7b1217973ad58d5461a7891efbb112f951f784e43</cites><orcidid>0000-0001-7480-4771</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00590-021-03157-z$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00590-021-03157-z$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27903,27904,41467,42536,51297</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34714391$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Gracia, G.</creatorcontrib><creatorcontrib>Laumonerie, P.</creatorcontrib><creatorcontrib>Tibbo, M. E.</creatorcontrib><creatorcontrib>Cavaignac, E.</creatorcontrib><creatorcontrib>Chiron, P.</creatorcontrib><creatorcontrib>Reina, N.</creatorcontrib><title>Outcomes of acute versus delayed total hip arthroplasty following acetabular fracture</title><title>European journal of orthopaedic surgery & traumatology</title><addtitle>Eur J Orthop Surg Traumatol</addtitle><addtitle>Eur J Orthop Surg Traumatol</addtitle><description>Purpose
Post-traumatic arthritis is known complication following acetabular fracture. The aim was to compare mid- to long-term outcomes of acute THA (aTHA) for acetabular fracture and delayed THA (dTHA) following failure of ORIF or conservative management.
Methods
We retrospectively analysed 60 THA (21 aTHA; 39 dTHA) performed for acetabular fracture between 2004 and 2014 in 60 patients with a mean age of 59 years (20–94). Functional and Radiographic outcomes were assessed at a mean follow-up of 5 years (2–13) utilizing Oxford, Harris Hip (HHS), and Postel Merle d’Aubigné (PMA) scores and Brooker classification.
Results
The mean HHS (73), Oxford (32) and PMA (12) scores were significantly lower in the aTHA group. Acute THA was significantly associated with lower postoperative Oxford (
β
= −4.2), HHS (
β
= −7.8), and PMA (
β
= −2.2) scores at mean 5 years (2–13). Eleven patients returned to the operating room. There were no significant differences between THA performed in acute or delayed fashion. The two primary reasons for revision were periprosthetic joint infection (
n
= 5) and aseptic loosening (
n
= 4). Survivorship free from reoperation at 10 years was 91% and 82% for aTHA and dTHA, respectively (
p
= 0.24). Increased PMA scores were associated with decreased overall survival of the THA free from reoperation (HR = 0.60). The degree of heterotopic ossification was significantly higher in the aTHA group (
p
< 0.001).
Conclusion
Acute THA in the setting of acetabular fracture is a technically challenging procedure. However, in the present series, aTHA provided satisfactory immediate stability and good survivorship at 10 years in a medically vulnerable patient population.
Level of Evidence
Level 3; Therapeutic study.</description><subject>Acetabulum - diagnostic imaging</subject><subject>Acetabulum - injuries</subject><subject>Acetabulum - surgery</subject><subject>Age</subject><subject>Arthritis</subject><subject>Arthroplasty, Replacement, Hip - adverse effects</subject><subject>Arthroplasty, Replacement, Hip - methods</subject><subject>Follow-Up Studies</subject><subject>Fractures</subject><subject>Hip Fractures - surgery</subject><subject>Hip Prosthesis - adverse effects</subject><subject>Humans</subject><subject>Hypotheses</subject><subject>Joint replacement surgery</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Original Article</subject><subject>Orthopedics</subject><subject>Patients</subject><subject>Prosthesis Failure</subject><subject>Reoperation</subject><subject>Retrospective Studies</subject><subject>Spinal Fractures - surgery</subject><subject>Surgical Orthopedics</subject><subject>Traumatic Surgery</subject><subject>Treatment Outcome</subject><issn>1432-1068</issn><issn>1633-8065</issn><issn>1432-1068</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp9kE1PGzEQhq2qqITAH-ihstQLl21n1ut4faxQC0hIuZCz5d2dTYKcOPijKPz6uoQWxIHTWJrnfcd6GPuM8A0B1PcIIDVUUGMFAqWqHj-wCTairhBm7cdX72N2EuMdAEqN8hM7Fo0qO40Ttpjn1PsNRe5HbvuciP-mEHPkAzm7p4Enn6zjq_WO25BWwe-cjWnPR--cf1hvlyVFyXbZ2cDHYPuUA52yo9G6SGfPc8oWv37eXlxVN_PL64sfN1UvlExV2ymiXgvQQg19C8MgVIPWqg5rVFoJO8h2kM0MrWo10th1iPWoJY6qbagRU3Z-6N0Ff58pJrNZx56cs1vyOZq6-EHUoLCgX9-gdz6HbfmdqdUMFMyk0oWqD1QffIyBRrML640Ne4Ng_ko3B-mmSDdP0s1jCX15rs7dhob_kX-WCyAOQCyr7ZLCy-13av8Au_WNXA</recordid><startdate>20230101</startdate><enddate>20230101</enddate><creator>Gracia, G.</creator><creator>Laumonerie, P.</creator><creator>Tibbo, M. E.</creator><creator>Cavaignac, E.</creator><creator>Chiron, P.</creator><creator>Reina, N.</creator><general>Springer Paris</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-7480-4771</orcidid></search><sort><creationdate>20230101</creationdate><title>Outcomes of acute versus delayed total hip arthroplasty following acetabular fracture</title><author>Gracia, G. ; Laumonerie, P. ; Tibbo, M. E. ; Cavaignac, E. ; Chiron, P. ; Reina, N.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c375t-8b7eec930937dc80dd3741aa7b1217973ad58d5461a7891efbb112f951f784e43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Acetabulum - diagnostic imaging</topic><topic>Acetabulum - injuries</topic><topic>Acetabulum - surgery</topic><topic>Age</topic><topic>Arthritis</topic><topic>Arthroplasty, Replacement, Hip - adverse effects</topic><topic>Arthroplasty, Replacement, Hip - methods</topic><topic>Follow-Up Studies</topic><topic>Fractures</topic><topic>Hip Fractures - surgery</topic><topic>Hip Prosthesis - adverse effects</topic><topic>Humans</topic><topic>Hypotheses</topic><topic>Joint replacement surgery</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Original Article</topic><topic>Orthopedics</topic><topic>Patients</topic><topic>Prosthesis Failure</topic><topic>Reoperation</topic><topic>Retrospective Studies</topic><topic>Spinal Fractures - surgery</topic><topic>Surgical Orthopedics</topic><topic>Traumatic Surgery</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Gracia, G.</creatorcontrib><creatorcontrib>Laumonerie, P.</creatorcontrib><creatorcontrib>Tibbo, M. E.</creatorcontrib><creatorcontrib>Cavaignac, E.</creatorcontrib><creatorcontrib>Chiron, P.</creatorcontrib><creatorcontrib>Reina, N.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>European journal of orthopaedic surgery & traumatology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Gracia, G.</au><au>Laumonerie, P.</au><au>Tibbo, M. E.</au><au>Cavaignac, E.</au><au>Chiron, P.</au><au>Reina, N.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Outcomes of acute versus delayed total hip arthroplasty following acetabular fracture</atitle><jtitle>European journal of orthopaedic surgery & traumatology</jtitle><stitle>Eur J Orthop Surg Traumatol</stitle><addtitle>Eur J Orthop Surg Traumatol</addtitle><date>2023-01-01</date><risdate>2023</risdate><volume>33</volume><issue>1</issue><spage>51</spage><epage>60</epage><pages>51-60</pages><issn>1432-1068</issn><issn>1633-8065</issn><eissn>1432-1068</eissn><abstract>Purpose
Post-traumatic arthritis is known complication following acetabular fracture. The aim was to compare mid- to long-term outcomes of acute THA (aTHA) for acetabular fracture and delayed THA (dTHA) following failure of ORIF or conservative management.
Methods
We retrospectively analysed 60 THA (21 aTHA; 39 dTHA) performed for acetabular fracture between 2004 and 2014 in 60 patients with a mean age of 59 years (20–94). Functional and Radiographic outcomes were assessed at a mean follow-up of 5 years (2–13) utilizing Oxford, Harris Hip (HHS), and Postel Merle d’Aubigné (PMA) scores and Brooker classification.
Results
The mean HHS (73), Oxford (32) and PMA (12) scores were significantly lower in the aTHA group. Acute THA was significantly associated with lower postoperative Oxford (
β
= −4.2), HHS (
β
= −7.8), and PMA (
β
= −2.2) scores at mean 5 years (2–13). Eleven patients returned to the operating room. There were no significant differences between THA performed in acute or delayed fashion. The two primary reasons for revision were periprosthetic joint infection (
n
= 5) and aseptic loosening (
n
= 4). Survivorship free from reoperation at 10 years was 91% and 82% for aTHA and dTHA, respectively (
p
= 0.24). Increased PMA scores were associated with decreased overall survival of the THA free from reoperation (HR = 0.60). The degree of heterotopic ossification was significantly higher in the aTHA group (
p
< 0.001).
Conclusion
Acute THA in the setting of acetabular fracture is a technically challenging procedure. However, in the present series, aTHA provided satisfactory immediate stability and good survivorship at 10 years in a medically vulnerable patient population.
Level of Evidence
Level 3; Therapeutic study.</abstract><cop>Paris</cop><pub>Springer Paris</pub><pmid>34714391</pmid><doi>10.1007/s00590-021-03157-z</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0001-7480-4771</orcidid></addata></record> |
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| identifier | ISSN: 1432-1068 |
| ispartof | European journal of orthopaedic surgery & traumatology, 2023-01, Vol.33 (1), p.51-60 |
| issn | 1432-1068 1633-8065 1432-1068 |
| language | eng |
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| source | MEDLINE; Springer Nature - Complete Springer Journals |
| subjects | Acetabulum - diagnostic imaging Acetabulum - injuries Acetabulum - surgery Age Arthritis Arthroplasty, Replacement, Hip - adverse effects Arthroplasty, Replacement, Hip - methods Follow-Up Studies Fractures Hip Fractures - surgery Hip Prosthesis - adverse effects Humans Hypotheses Joint replacement surgery Medicine Medicine & Public Health Middle Aged Original Article Orthopedics Patients Prosthesis Failure Reoperation Retrospective Studies Spinal Fractures - surgery Surgical Orthopedics Traumatic Surgery Treatment Outcome |
| title | Outcomes of acute versus delayed total hip arthroplasty following acetabular fracture |
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