Total hip arthroplasty with cementless cup after acetabular fracture

Abstract

Background Acetabular fractures are a common cause of degenerative hip arthritis. The incidence of post-traumatic osteoarthritis has been reported between 12% and 57% and avascular necrosis of the femoral head may occur in 2% to 40% after posterior fracture dislocation. The fracture is often caused by major trauma in road accidents, at work or during sports, and patients usually present for total hip replacement (THR) at an earlier age than the general arthritic population. We describe and analyze our patients with uncemented acetabular reconstruction in post-traumatic arthritis and compare them with THR in non-traumatic arthritis. Methods We retrospectively evaluated 19 patients who underwent uncemented acetabular reconstruction due to post-traumatic arthritis secondary to acetabular fracture. Results The average age at the time of arthroplasty was 52.2 years (19-83). The age at the time of fracture was 47.9 years (16-81). The average time between the acetabular fracture and THR was 52.4 months (4-360). The average follow-up was 4.25 years. No acetabular component loosening or infections were seen in either group. The Harris Hip Score at an average follow-up of 4.25 years was 89.3 (57-99). The follow-up in the control group with non-traumatic arthritis was 4.9 years, and the Harris Hip Score was 94.1 points (78-100). There were no significant difference in the Harris Hip Score between groups (p = 0.24). Conclusion Uncemented acetabular reconstruction in post-traumatic arthritis secondary to acetabular fracture is a more difficult procedure than routine arthroplasty in patient with non-traumatic arthritis. In the short-term there are no clinical or radiographic differences in THR with uncemented acetabular cups in post-traumatic arthritis patients compared to patients with non-traumatic arthritis.

Keywords

• fractura de acetábulo, reemplazo total de cadera, copa no cementada.