Back to Search
Start Over
Outcomes of Total Hip Arthroplasty After Acetabular Open Reduction and Internal Fixation in the Elderly-Acute vs Delayed Total Hip Arthroplasty
- Source :
- The Journal of arthroplasty. 36(2)
- Publication Year :
- 2020
-
Abstract
- Optimum management for the elderly acetabular fracture remains undefined. Open reduction and internal fixation (ORIF) in this population does not allow early weight-bearing and has an increased risk of failure. This study aimed to define outcomes of total hip arthroplasty (THA) in the setting of an acetabular fracture and compared delayed THA after acetabular ORIF (ORIF delayed THA) and acute fixation and THA (ORIF acute THA).All acetabular fractures in patients older than 60 years who underwent ORIF between 2007 and 2018 were reviewed (n = 85). Of those, 14 underwent ORIF only initially and required subsequent THA (ORIF delayed THA). Twelve underwent an acute THA at the time of the ORIF (ORIF acute THA). The ORIF acute THA group was older (81 ± 7 vs 76 ± 8; P.01) but had no other demographic- or injury-related differences compared with the ORIF delayed THA group. Outcome measures included operative time, length of stay, complications, radiographic assessments (component orientation, leg-length discrepancy, heterotopic ossification), and functional outcomes using the Oxford Hip Score (OHS).Operative time (P = .1) and length of stay (P = .5) for the initial surgical procedure (ORIF only or ORIF THA) were not different between groups. Four patients had a complication and required further surgeries; no difference was seen between groups. Radiographic assessments were similar between groups. The ORIF acute THA group had a significantly better OHS (40.1 ± 3.9) than the ORIF delayed THA group (33.6 ± 8.5) (P = .03).In elderly acetabulum fractures, ORIF acute THA compared favorably (a better OHS, single operation/hospital visit, equivalent complications) with ORIF delayed THA. We would thus recommend that in patients with risk factors for failure requiring delayed THA (eg, dome or roof impaction) that ORIF acute THA be strongly considered.
- Subjects :
- musculoskeletal diseases
medicine.medical_specialty
medicine.medical_treatment
Arthroplasty, Replacement, Hip
Population
03 medical and health sciences
Fracture Fixation, Internal
Fractures, Bone
0302 clinical medicine
health services administration
Medicine
Internal fixation
Humans
Orthopedics and Sports Medicine
In patient
education
Aged
Retrospective Studies
030222 orthopedics
education.field_of_study
business.industry
Impaction
Hip Fractures
Acetabular fracture
Acetabulum
equipment and supplies
musculoskeletal system
medicine.disease
Surgery
Open Fracture Reduction
surgical procedures, operative
Treatment Outcome
business
Complication
Total hip arthroplasty
Subjects
Details
- ISSN :
- 15328406
- Volume :
- 36
- Issue :
- 2
- Database :
- OpenAIRE
- Journal :
- The Journal of arthroplasty
- Accession number :
- edsair.doi.dedup.....2b85a338db722a8f2174eb8dfcec52e4