Total Hip Replacement after Acetabular Fracture Fixation: Surgical Challenges, Techniques, and Outcomes

Area of Science:

• Orthopedic Surgery
• Trauma Surgery
• Arthroplasty

Background:

• Acetabular fractures frequently lead to post-traumatic arthritis and chronic hip pain.
• Total hip replacement (THR) is a reliable solution for severe cases.
• Performing THR after acetabular fracture fixation presents unique surgical challenges.

Purpose of the Study:

• To evaluate the surgical difficulties, complications, and functional outcomes of THR following acetabular fracture fixation.
• To assess the effectiveness of THR in patients with a history of acetabular fracture repair.

Main Methods:

• Retrospective study of 31 patients undergoing THR after acetabular fracture fixation.
• Data collected included demographics, fracture patterns, surgical approaches, and implant types.
• Functional outcomes were measured using the Harris Hip Score (HHS) pre- and post-operatively.
• Radiological assessments evaluated component alignment and implant fixation.

Main Results:

• Mean pre-operative HHS improved significantly from 48 to 85 (P < 0.001).
• Major intraoperative challenges included implant removal (30%), poor bone stock (20%), and component positioning (26.7%).
• Complications were minimal, with one case of transient sciatic neuropraxia; no deep infections, dislocations, or early loosening occurred.

Conclusions:

• Total hip replacement after acetabular fracture fixation is technically demanding but achieves excellent functional results.
• Meticulous surgical planning and appropriate implant selection are crucial for success.
• Both cemented and uncemented THR options demonstrated satisfactory fixation.