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Total hip arthroplasty in acetabular fractures
Deepak Gautam1, Saurabh Gupta1, Rajesh Malhotra2
1All India Institute of Medical Sciences, Ansari Nagar, New Delhi, Delhi, 110029, India.
Journal of Clinical Orthopaedics and Trauma
|November 16, 2020
Summary
Total hip arthroplasty (THA) effectively treats hip arthritis after acetabular fractures. Surgical planning and modern implants are crucial for successful outcomes, especially in elderly patients.
Area of Science:
- Orthopedic Surgery
- Trauma Surgery
- Arthroplasty
Background:
- Acetabular fractures often lead to hip arthritis, necessitating Total Hip Arthroplasty (THA).
- Acute THA is increasingly used for fractures with pre-existing arthritis or poor fixation prognosis.
- Elderly patients with osteoporosis present unique challenges in THA for acetabular fractures.
Purpose of the Study:
- To outline the surgical considerations and preferred techniques for performing Total Hip Arthroplasty (THA) in the context of acetabular fractures.
- To highlight strategies for managing surgical challenges, particularly in elderly patients.
Main Methods:
- Meticulous preoperative planning using radiographs and CT scans.
- Ensuring adequate surgical exposure to identify fracture patterns.
- Utilizing a range of instruments and implants, including press-fit uncemented acetabular components.
Main Results:
- Restoring acetabular columns for component implantation is the primary surgical goal.
- Press-fit uncemented acetabular components with screw fixation are generally preferred.
- Complex fractures may necessitate revision THA implants and major reconstruction.
Conclusions:
- Successful THA for acetabular fractures relies on detailed planning, adequate exposure, and appropriate implant selection.
- Careful management is required for elderly patients to ensure stable fixation and early weight-bearing.
- Revision implants may be necessary for complex cases, including those with pelvic discontinuity.
