THA in patients with neglected acetabular fractures

Area of Science:

• Orthopedic Surgery
• Trauma Surgery
• Arthroplasty

Background:

• Total hip arthroplasty (THA) outcomes are poorer in neglected acetabular fractures due to bone deficiency.
• Acetabular reconstruction and bone grafting complicate these procedures.
• Clinical outcomes of THA for neglected acetabular fractures are understudied.

Purpose of the Study:

• To evaluate surgical techniques for THA in neglected acetabular fractures.
• To describe functional and radiological outcomes of different THA approaches.
• To assess outcomes in a single-surgeon series.

Main Methods:

• Retrospective study of 51 neglected acetabular fractures in 49 patients.
• Treatment options included THA alone, open reduction with internal fixation and THA, or acetabular defect reconstruction THA.
• Focus on surgical technique, functional, and radiological outcomes.

Main Results:

• Significant improvement in 90% of patients based on Harris Hip score.
• Encouraging long-term clinical improvement.
• Radiographic restoration of acetabular bone stock and center of rotation achieved.

Conclusions:

• Neglected fracture-dislocations with structural support loss can be treated successfully with THA and bone grafting.
• Bony reconstruction and cementless components ensure long-term survival.
• Preservation of bone stock facilitates future THA revisions.