Rate- and Patient-Specific Risk Factors for Periprosthetic Acetabular Fractures During Primary Total Hip Arthroplasty...

Area of Science:

• Orthopedic Surgery
• Biomaterials Science
• Radiology

Background:

• Periprosthetic acetabular fractures are a complication of primary total hip arthroplasty (THA) with cementless components.
• Fractures can range from occult to severe, impacting patient outcomes.

Purpose of the Study:

• To evaluate the perioperative periprosthetic acetabular fracture rate following primary cementless THA.
• To identify patient-specific risk factors associated with these fractures.

Main Methods:

• Analysis of 7,016 primary THAs using cementless, hydroxyapatite-coated, modular titanium acetabular components.
• Review of perioperative radiographs and CT scans, with AI-based analysis for measurements.
• Comparison of patients with and without periacetabular fractures to determine risk factors.

Main Results:

• The overall fracture rate was 0.8% (56/7,016), with 71.4% being small and non-operative.
• Revision THA was required in 0.2% (16/7,016) of cases.
• Identified risk factors include small acetabular component size, low BMI, advanced age, female sex, and specific radiographic parameters (low lateral CE angle, high extrusion index, high Sharp and Tönnis angles).

Conclusions:

• A significant proportion of periprosthetic acetabular fractures are minor and do not require revision surgery.
• Patient-specific factors, including advanced age, female sex, low BMI, and hip dysplasia, are associated with increased fracture risk.
• Understanding these risk factors can aid in preventing future complications.