Acute Total Hip Arthroplasty in Acetabular Fractures in Korea: National Claim Database Study

The purpose of this study was 1) to analyze the proportion of acute total hip arthroplasty (THA) for acetabular fractures and 2) to evaluate the clinical outcomes of acute THA in South Korea using a medical claims database.

This retrospective registry study utilized the Korean Health Insurance Review and Assessment database. Patients diagnosed with acetabular fractures from January 2007 to December 2018 were identified using the International Classification of Diseases-10 code. Acute THA was defined as those who had a procedural code of THA during the hospitalization. Kaplan-Meier survival analyses with total revisions, cup revisions, and stem revisions as endpoints were used to evaluate the clinical outcomes.

Among 14,088 patients with acetabular fractures, 153 patients (1.1%) were treated with acute THA. The mean follow-up period was 5.8 ± 3.9 years (range, 0.2 to 12 years). There were 22 reoperations (14.4%) including 12 cup revisions, 8 total revisions, and 2 stem revisions. Cumulative incidence at 10 years was 7.8% for acetabular cup revisions, 1.4% for femoral stem revisions, 5.1% for total revisions. Survivorship with a cup revision as the end point was 92.1% (95% confidence interval, 87.0% to 97.8%) at 10 years.

The proportion of acute THA was 1.1% in treatment for acetabular fracture, and decreased in South Korea. These might be associated with the suboptimal clinical results of acute THA for acetabular fracture.