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Young patients with acetabular fractures show comparable results when treated with ORIF, acute THA

Issue: November 2013

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PHOENIX — Researchers found comparable results between open reduction internal fixation and acute total hip arthroplasty to treat patients younger than 65 years who have acetabular fractures, according to a presenter at the Orthopaedic Trauma Association Annual Meeting, here.

"Our conclusion is that acute total hip arthroplasty, even in slightly younger patients who are victims of high-energy trauma, can provide reliable and higher functional outcomes than those who undergo [open reduction internal fixation] ORIF alone in those with hybrid fractures," Carol A. Lin, MD, MA, said. "However, our indications for this procedure require some additional investigation and we do need some larger prospective comparison studies."

Lin and colleagues retrospectively followed 16 patients who underwent total hip arthroplasty (THA) and 32 patients who underwent ORIF for acetabular fractures involving the posterior wall between 1996 and 2011 at a level I trauma center, according to the abstract. The patients had an average 6.2 years of follow-up and were mean 56.4 years old at the time of surgery.

There were no significant differences between the proportions of the high-energy mechanism of injury between the two groups. However, Lin and colleagues noted full-thickness cartilage injury to the femoral head, involvement of the weight-bearing dome and marginal impaction rates were significantly different.

In the ORIF group, 12 patients eventually underwent THA and these conversions occurred in 75% of patients at 1-year follow-up and 83% of cases at 2-year follow-up, according to the abstract. For patients who underwent THA, one patient had an infection and a second patient had a loose cup at the last follow-up.

Reference:

Lin CA. Paper #34. Presented at: Orthopaedic Trauma Association Annual Meeting. Oct. 9-12, 2013; Phoenix.

Disclosure: One of the authors (Schmidt) is a paid consultant for and receives royalties from Smith & Nephew and receives royalties from CFI Medical.