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. 2021 Apr;45(4):871-876.
doi: 10.1007/s00264-020-04676-w. Epub 2020 Jul 2.

Total hip arthroplasty after acetabular fracture surgery

Sasa Milenkovic  1   2 , Milan Mitkovic  3   4 , Milorad Mitkovic  3 , Predrag Stojiljković  3   4
Affiliations

Total hip arthroplasty after acetabular fracture surgery

Sasa Milenkovic et al. Int Orthop. 2021 Apr.

Abstract

Purpose: Acetabular fractures are accompanied by complications such as post-traumatic osteoarthritis (OA) of the hip and avascular necrosis (AVN) of the femoral head. The aim of the study was to evaluate improvement of life quality and functional recovery after total hip arthroplasty (THA) in patients with post-traumatic OA and AVN.

Methods: We retrospectively reviewed 23 patients with post-traumatic OA of the hip and AVN of the femoral head who undergone THA, out of 63 patients who were previously surgically treated for acetabular fractures. Final functional outcomes are defined according to the Merle d'Aubigné score, and the pain intensity according to VAS from 0 to 10.

Results: Out of 63 patients with acetabular fractures from 2008 to 2018, we analyzed 23 (36.5%) patients, with an average age of 51.5 ± 13.8 years, who required THA due to post-traumatic OA and AVN of the femoral head. THA was done after the average of 4.28 years (range 1 to 8) from previous acetabular osteosynthesis. According to Merle d'Aubigné score, final functional outcomes before THA were moderate with average points of 4.86 (4-6). Post-THA final functional outcomes were excellent with an average point of 10.04 (10-12) (p < 0.001). The ratio of VAS before and after THA was 9.04:1.95(p < 0.001).

Conclusion: THA is a method which gives the best results in the treatment of post-traumatic OA of the hip and AVN of the femoral head after previous osteosynthesis of the acetabular fracture. After THA, life quality and functional status of a patient are significantly improved.

Keywords: Acetabulum; Fracture; Post-traumatic osteoarthritis; Total hip arthroplasty.

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