Abstract
Abstract. Introduction Total hip replacement is the most effective technique for the consequences of acetabular fractures. The study includes the literature review on the outcomes of total hip replacement (THR) in patients with post-traumatic coxarthrosis. Material and methods The search was performed via databases of PUBMED, SCOPUS, Google Scholar, Cochrane library, E-library and publications using the keywords “acetabulum”, “fracture”, “total hip arthroplasty” and “post-traumatic arthritis” published between 1995 and 2020. The exclusion criteria were a series of less than 10 patients, a follow-up period of less than 12 months. Abstracts of the meetings and review articles published either in Russian or in English were included in the study. Patients' demographic data, surgical characteristics and outcomes were reviewed. Results Total 1,843 publications were reviewed and the analysis included data from 20 studies with the total number of 1,184 cases reviewed. Surgical treatments of the patients were performed between 1984 and 2018. The follow–up period averaged to 5.5 ± 1.19 years (range, 2 to 18 years). The mean age of the patients was 56.4 ± 12.7 years. The mean interval from an injury to total hip arthroplasty was 8 ± 2.7 years. The mean Harris Hip Score was 39.4 ± 11 prior to surgery and 86.2 ± 22 postoperatively. The most common postoperative complications were heterotopic ossification (28.9 ± 10 %), aseptic loosening (8.15 ± 1.82 %) and periprosthetic joint infection (7.89+1.86 %). Complications that required revision surgery were noted in 13.47 ± 2.91 % cases. Conclusion THR in patients who sustained acetabular fractures is challenging, and bone grafts or acetabular augments would be needed to address an acetabular defect of any localization.
Highlights
Total hip replacement is the most effective technique for the consequences of acetabular fractures
Acetabular fractures primarily occur in young people who are involved in high-velocity trauma [2]
Ten studies reported an interval between the injury and total arthroplasty with the mean period of 8 ± 2.7 years ranging from 3.1 to 20 years with the median of 6.7 years
Summary
Total hip replacement is the most effective technique for the consequences of acetabular fractures. The study includes the literature review on the outcomes of total hip replacement (THR) in patients with post-traumatic coxarthrosis. Acetabular fractures primarily occur in young people who are involved in high-velocity trauma [2] The consequences of such injuries significantly reduce the quality of life and cause permanent disability [3–6]. Total hip replacement (THR) is the preferred method of treatment, for elderly patients, in particular [7–9]. THR in patients with acetabulum injuries is associated with difficulties including acetabular defects that prevent achieving a strong primary fixation of standard acetabular components, disturbed anatomical relationships in the joint, pronounced soft tissue scars, the presence of metal constructs, an increased risk of implant related infection, avascular necrosis of the femoral head with limited possibilities for bone autografts [13, 14 ]. The AAOS acetabular classification being common in the USA[19] allows to accurately localize the defect of any etiology (both post-traumatic and post-implantation) and represent its nature, but the classification fails to reflect the severity of the changes and determine the strategy of defect reconstruction and implantation technique of the acetabular component [20, 21]
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