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Total hip replacement in complex acetabular fractures using a coned hemipelvic acetabular component.

Samuel E McMahon1, Laurence A Cusick2

  • 1Royal Victoria Hospital, Belfast, BT12 6BA, Northern Ireland, UK. sammc84@gmail.com.

European Journal of Orthopaedic Surgery & Traumatology : Orthopedie Traumatologie
|January 24, 2017
PubMed
Summary

This study introduces a new coned hemipelvic acetabular component for treating elderly acetabular fractures, enabling early weight-bearing and promising functional outcomes with minimal complications.

Keywords:
Acetabular fractureAcetabular fracture fixationHemipelvisOsteoporotic fracture

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Area of Science:

  • Orthopedic Surgery
  • Geriatric Trauma
  • Arthroplasty

Background:

  • Acetabular fractures in the elderly present significant challenges due to osteoporosis and comorbidities.
  • These fractures are linked to poor functional results and increased mortality.
  • Current treatments include conservative management, open reduction internal fixation, and total hip arthroplasty.

Purpose of the Study:

  • To present the surgical technique and early outcomes of using a coned hemipelvic acetabular component for primary treatment of acetabular fractures in elderly patients.
  • To evaluate the safety and efficacy of this novel approach in improving functional recovery.

Main Methods:

  • A prospective study involving five elderly patients (six cases) with a mean age of 75 years.
  • Surgical technique involved the implantation of a coned hemipelvic acetabular component.
  • Patients were followed up for 15 months, assessing complications, mobility, and radiological outcomes.

Main Results:

  • Four out of five patients achieved independent ambulation with a walking aid at latest follow-up.
  • Early weight-bearing mobilization was possible on postoperative day one for four patients.
  • Minor complications included wound ooze, acute kidney injury, and respiratory infection; no dislocations, infections, or prosthesis migration occurred.

Conclusions:

  • The coned hemipelvic acetabular component provides an immediately stable construct, facilitating early mobilization.
  • This technique shows promising early results for treating complex acetabular fractures in the elderly.
  • Further long-term monitoring is recommended to confirm sustained benefits and safety.