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J Orthop Trauma. 2014 Jun 26. [Epub ahead of print]

Functional Outcomes after Total Hip Arthroplasty for the Acute Management of Acetabular Fractures: 1 to 14 year Follow Up.

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  • 1‚ĆHennepin County Medical Center, Dept. of Orthopedic Surgery, 701 Park Avenue, mailcode G2, Minneapolis, MN, USA 55415 *Sanford Bemidji Orthopedics, 3807 Greenleaf Ave NW, Bemidji, MN 56601 ‚Ä°University of Minnesota School of Medicine, 420 Delaware Street Southeast, Minneapolis, MN 55455.

Abstract

OBJECTIVE::

This study reports the complications and functional outcomes in patients treated acutely with combined open reduction internal fixation (ORIF) and immediate THA for displaced, comminuted acetabular fractures.

DESIGN::

Single surgeon retrospective case series SETTING:: Level 1 trauma center PATIENTS:: Thirty-three consecutive patients (18 female, mean age 66 years) from 1996-2011 with an average follow-up was 5.6 years (range, 1 to 14.3 years).

INTERVENTION::

ORIF and immediate THA MAIN OUTCOME MEASUREMENTS:: Oxford Hip Score and reoperation METHODS:: All patients had at least one year of telephone or clinical follow-up. Postoperative complications, reoperations, and available radiographs were reviewed.

RESULTS::

Six patients died from causes unrelated to their injuries or surgery; prior to death these patients had well-functioning hips. There was a 15% complication rate. At last follow up, 94% of hips remained in-situ and were functioning well. The average Oxford Hip Score at final follow-up was 17 (range 12 to 32), with 93% of patients reporting good to excellent function. There was no statistical association between fracture type, age, or fixation type and outcome.

CONCLUSION::

Acute ORIF and immediate THA for selected acetabular fractures is a safe, viable treatment option with good to excellent functional outcomes and may reduce the need for two separate operations in many patients. Functional outcomes are equivalent to those after primary THA for osteoarthritis. This study does not address at which age acute THA is a cost-effective treatment option.

LEVEL OF EVIDENCE::

Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

PMID:
24978942
[PubMed - as supplied by publisher]
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