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Update on post-traumatic periprosthetic acetabular fractures.

Mohamed A Selmene^1,2, Pierre E Moreau¹, Mourad Zaraa¹

¹Orthopaedic Department, Paris Saint-Joseph Hospital Group, Paris, France.

Bone & Joint Open

|January 18, 2024

Summary

Post-traumatic acetabular fractures often have a transverse component, leading to implant instability and high complication rates like dislocations. Combining osteosynthesis with acetabular reconstruction improved surgical outcomes.

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Area of Science:

Orthopedic Surgery
Trauma Surgery
Arthroplasty

Background:

Post-traumatic periprosthetic acetabular fractures are rare but severe complications following hip arthroplasty.
Existing literature on these fractures is limited due to small patient cohorts.

Purpose of the Study:

To characterize post-traumatic periprosthetic acetabular fractures.
To evaluate the functional outcomes and complication rates of surgical management.

Main Methods:

Retrospective review of 20 patients over six years (2016-2021).
Data collected included demographics, prosthesis details, trauma characteristics, and treatment type.
Functional outcomes assessed using the Harris Hip Score (HHS); complications meticulously recorded.

Main Results:

The study included 20 patients (mean age 77 years), all with comorbidities.
75% had pure transverse fractures; 90% had a transverse component, often destabilizing the acetabular implant.
Mean HHS was 75.5; common complications included dislocations (30%), infections (20%), and need for revision surgery (30%).

Conclusions:

Post-traumatic periprosthetic acetabular fractures frequently exhibit a transverse component, increasing implant destabilization risk.
High complication rates, particularly dislocations, necessitate frequent revision surgeries.
Combined osteosynthesis and acetabular reconstruction yielded the best surgical outcomes, suggesting improved preoperative planning is crucial.