Early Conversion Total Hip Arthroplasty for High-Energy Acetabular Fractures Is Associated With Poor Outcomes

Area of Science:

• Orthopedic Surgery
• Trauma Surgery
• Arthroplasty

Background:

• Conversion total hip arthroplasty (THA) is a salvage procedure for posttraumatic arthritis after acetabular fracture fixation (ORIF).
• Historically, high failure rates were linked to acetabular loosening, but modern techniques show promise.
• This study evaluates early conversion THA outcomes after high-energy acetabular fractures.

Purpose of the Study:

• To assess the outcomes and survivorship of early conversion THA following ORIF of acetabular fractures.
• To identify common complications and revision rates in this patient cohort.

Main Methods:

• Retrospective review of 144 patients undergoing acetabular ORIF and conversion THA (2002-2022).
• Exclusion of patients with <1 year follow-up without complications.
• Data collected included demographics, injury details, ORIF/THA perioperative information, complications, and reoperations/revisions.

Main Results:

• 144 cases included; average age 51.3 years at ORIF.
• Median time from ORIF to THA was 1.1 years.
• Complications occurred in 32.6% (dislocation 13.2%, infection 11.8%). Reoperation/revision rates were 21.5%/18.1%, with most revisions within the first year.

Conclusions:

• Early conversion THA after acetabular ORIF is linked to significant complication and revision rates.
• Instability and infection are major concerns, outweighing aseptic loosening.
• Improved management strategies are crucial for this challenging patient group.