Total Hip Arthroplasty Alone for Treatment of Selected Acetabular Fractures in Older Patients

2019 ◽  
pp. 97-112
Author(s):  
John M. Whatley ◽  
Andrew H. Schmidt ◽  
Theodore T. Manson
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Older Patients ◽  
Acetabular Fractures ◽  
Total Hip

scholarly journals Acute total hip arthroplasty for older patients with acetabular fractures: A meta-analysis

2020 ◽  
Vol 11 (6) ◽  
pp. 976-982
Author(s):  
Julio J. Jauregui ◽  
Tristan B. Weir ◽  
Jin F. Chen ◽  
Aaron J. Johnson ◽  
Neil R. Sardesai ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Older Patients ◽  
Meta Analysis ◽  
Acetabular Fractures ◽  
Total Hip

scholarly journals Early Total Hip Arthroplasty for the Treatment of Acetabular Fractures

2019 ◽  
Vol 03 (03) ◽  
pp. 161-170
Author(s):  
Michael C. Willey ◽  
Elizabeth Scott ◽  
J Lawrence Marsh
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Older Patients ◽  
Posterior Wall ◽  
Physiological Age ◽  
Acetabular Fractures ◽  
Fixation Failure ◽  
Radiographic Findings ◽  
Total Hip ◽  
Posterior Wall Fractures

AbstractEarly total hip arthroplasty in patients with acetabular fractures is considered in rare situations with specific indications. Generally, this treatment option is considered in patients older than 55 or 60 years, but the physiological age must also be considered. The patient should be functional and ambulatory before the injury and healthy enough to tolerate the insult of a surgical procedure of this magnitude. Preexisting conditions such as osteoporosis and osteoarthritis encourage consideration of total hip arthroplasty. Specific injury patterns are predictive of fixation failure in older patients with acetabular fractures. These findings represent worse articular injury and low bone density that would intuitively lead to failure. This “gull sign” or “seagull sign” describes either the central–superior dome impaction seen in high-transverse fractures or the impaction of the subchondral bone on the intact edge of a partial posterior column fracture. Other radiographic predictors of failure in posterior wall fractures include comminution of more than three fragments, involvement of the superior dome in high posterior wall fractures, and marginal impaction. Older patients have a high incidence of these radiographic findings, predictive of fixation failure without arthroplasty. Other injury characteristics including concomitant displaced femoral neck fracture and femoral head injury are also indications for total hip arthroplasty in older patients. Acute hip arthroplasty can be performed using the posterolateral, direct lateral, anterolateral, and anterior approaches to the hip. There are also reports of patients who underwent combined approaches to the hip for stabilization of the injury using the anterior intrapelvic approach and ilioinguinal approach. Combined approaches are generally not recommended. Extended approaches are not recommended or necessary for early arthroplasty in acetabular fractures. This review article highlights recent trends of early total hip arthroplasty in senior patients with acetabular fracture, and the indications for the procedure, complications, clinical outcomes, and technical considerations, with cases to highlight these concepts.

scholarly journals Treatment of acetabular fractures in older patients-introduction of a new implant for primary total hip arthroplasty

2017 ◽  
Vol 137 (4) ◽  
pp. 549-556 ◽  
Author(s):  
H. Resch ◽  
D. Krappinger ◽  
P. Moroder ◽  
A. Auffarth ◽  
M. Blauth ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Older Patients ◽  
Acetabular Fractures ◽  
Total Hip ◽  
Primary Total Hip Arthroplasty

scholarly journals The influence of bone quality on radiological outcome in 50 consecutive acetabular fractures treated with a pre-contoured anatomic suprapectineal plate

2021 ◽  
Author(s):  
Maximilian J. Hartel ◽  
Tareq Naji ◽  
Florian Fensky ◽  
Frank O. Henes ◽  
Darius M. Thiesen ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Bone Mass ◽  
Bone Quality ◽  
Hip Arthroplasty ◽  
Mass Density ◽  
Acetabular Fractures ◽  
Bone Mass Density ◽  
Radiological Outcome ◽  
Total Hip ◽  
The Impact

Abstract Purpose To investigate the range of indications of an anatomical-preshaped three-dimensional suprapectineal plate and to assess the impact of the bone mass density on radiologic outcomes in different types of acetabular fractures. Patients and methods A consecutive case series of 50 acetabular fractures (patient age 69 ± 23 years) treated with suprapectineal anatomic plates were analyzed in a retrospective study. The analysis included: Mechanism of injury, fracture pattern, surgical approach, need for additional total hip arthroplasty, intra- or postoperative complications, as well as bone mass density and radiological outcome on postoperative computed tomography. Results Most frequently, anterior column fracture patterns with and without hemitransverse components as well as associated two column fractures were encountered. The anterior intrapelvic approach (AIP) was used in 98% (49/50) of the cases as primary approach with additional utilization of the first window of the ilioinguinal approach in 13/50 cases (26%). Determination of bone density revealed impaired bone quality in 70% (31/44). Postoperative steps and gaps were significantly greater in this subgroup (p < 0.05). Fracture reduction quality for postoperative steps revealed anatomic results in 92% if the bone quality was normal and in 46% if impaired (p < 0.05). In seven cases (14%), the plate was utilized in combination with acute primary arthroplasty. Conclusion A preshaped suprapectineal plate provides good radiological outcomes in a variety of indications in a predominantly geriatric cohort. Impaired bone quality has a significantly higher risk of poor reduction results. In cases with extensive joint destruction, the combination with total hip arthroplasty was a valuable option.

Functional Recovery Following Uncomplicated Unilateral Total Hip Arthroplasty in Older Patients

2004 ◽  
Vol 20 (4) ◽  
pp. 309-310 ◽  
Author(s):  
S. B. Ganz ◽  
S. I. Backus ◽  
R. A. Benick ◽  
A. Espinal
Keyword(s):  
Total Hip Arthroplasty ◽  
Functional Recovery ◽  
Hip Arthroplasty ◽  
Older Patients ◽  
Total Hip

scholarly journals Acetabular Fractures in the Elderly

2015 ◽  
Vol 6 ◽  
pp. CMTIM.S12265 ◽  
Author(s):  
Joshua L. Gary
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Acetabular Fracture ◽  
Open Reduction ◽  
Weight Bearing ◽  
Revision Arthroplasty ◽  
Early Mobilization ◽  
Acetabular Fractures ◽  
Posttraumatic Arthritis ◽  
Total Hip

As the population ages, the incidence of osteoporotic fractures, including those of the pelvis and acetabulum, continues to rise. Treatment of the elder patients with an acetabular fracture is much more controversial than the treatment of younger patients with similar injuries, where prevention of posttraumatic arthritis and total hip replacement remains optimal to limit need for revision arthroplasty. Arthroplasty for fractures of the proximal femur is commonplace in an older population and is a mainstay of treatment to promote early mobilization and weight-bearing. However, even with acute total hip arthroplasty for a geriatric acetabular fracture, most surgeons do not permit immediate weight-bearing postoperatively. Therefore, controversy regarding optimal treatment of these challenging fractures persists. Four treatment options have emerged: nonoperative treatment with early mobilization, open reduction and internal fixation (ORIF), limited open reduction and percutaneous screw fixation, and acute total hip arthroplasty. The exact indications and benefits of each treatment remain unknown. This article serves as a review of these four treatments and the data existing to support them.

Cementless total hip arthroplasty in the treatment after acetabular fractures

2017 ◽  
Vol 28 (1) ◽  
pp. 59-64 ◽  
Author(s):  
Wael Salama ◽  
Paolo Ditto ◽  
Shazly Mousa ◽  
Abdelrahman Khalefa ◽  
Ahmed Sleem ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Acetabular Fractures ◽  
Total Hip ◽  
Cementless Total Hip Arthroplasty
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