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. 2024 Mar;48(3):667-674.
doi: 10.1007/s00264-023-05988-3. Epub 2023 Sep 19.

Incidence and outcomes of intraoperative periprosthetic acetabular fractures during cementless total hip arthroplasty: a prospective three-dimensional computer tomography-based study

You-Seung Chun  1 , Hwan-Hee Lee  2 , Young-Wook Lim  3 , Yong-Sik Kim  3 , Soon-Yong Kwon  3 , Seung-Chan Kim  4
Affiliations

Incidence and outcomes of intraoperative periprosthetic acetabular fractures during cementless total hip arthroplasty: a prospective three-dimensional computer tomography-based study

You-Seung Chun et al. Int Orthop. 2024 Mar.

Abstract

Purpose: Unlike periprosthetic femoral fractures, periprosthetic acetabular fractures during total hip arthroplasty (THA) have not been evaluated in detail. We prospectively evaluated the incidence, patterns, risk factors, and clinical outcomes of intraoperative periprosthetic acetabular fractures using pre- and postoperative computer tomography (CT).

Methods: In this prospective single-centre study, we evaluated 234 consecutive patients (250 hips) who underwent THA and three-dimensional CT before and after the surgery. We assessed the incidence, pattern of fractures, outcomes for each fracture pattern, reoperation and revision rates, Harris hip score, and visual analog scale (VAS) for pain. Multivariate regression models were used to identify risk factors for periprosthetic acetabular fractures.

Results: In total, 43 periprosthetic acetabular fractures (17.2%) were identified via CT. Fractures occurred most frequently at the superolateral wall. Early cup migration occurred in three hips. None of the patients underwent revision surgery for acetabular loosening. Regression modeling showed that rheumatoid arthritis was a significant predictor of periprosthetic acetabular fractures.

Conclusions: Periprosthetic acetabular fractures are not infrequent during cementless THA and are more common in patients with rheumatoid arthritis.

Keywords: Acetabulum; Computed tomography; Outcomes; Periprosthetic fracture; Risk factor; Total hip arthroplasty.

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