Hüftprothesenimplantation nach Azetabulumfraktur- Klinische und radiologische Outcomeanalyse

Abstract

Total Hip Arthroplasty (THA) is a challenging option for treatment of posttraumatic arthritis caused by acetabular fractures.

The study aimed to determine the short- and midterm clinical and radiographic results of THA following acetabular fracture. Our findings were compared with studies that also investigated the issue of posttraumatic arthritis after acetabular fracture. Furthermore, the fracture pattern, the extent of injury and the initial fracture treatment were considered to evaluate the influence of these factors on the clinical-radiographic outcome.

68 patients who received THA for treatment of posttraumatic osteoarthritis after acetabular fracture between January 2007 and December 2012 were analyzed retrospectively. The group consisted of 14 female (21%) and 54 male (79%) patients with a medium age of 59 (25-87) years at the time of THA. The interval between injury and THA was 107 (0-504) months on average. The all cause 8-year survival-rate was 0,87 (0,76-0,93) % and there were 8 revisions. Half of the revisions were due to aseptic loosening of the cup and done after an average period of 34,5 ± 30,8 (2-74) months. The Harris-Hip-Score achieved 75,7 ± 21,3 (26,9-100) points. Prior to THA heterotopic ossifications were detected in 28% and after THA implantation in 42%. Radiolucencies surrounding the implanted cup could be found in 4%.

The decrease of the interval between injury and arthroplasty was associated with increasing patient age (p=0,001). Complex fracture patterns were accompanied by more often acetabular bone defects more often than simple fracture patterns (p=0,03). Heterotopic ossifications increased after THA.