Abstract
Background Intraoperative acetabular fracture(IAF)is a rare complication of primary total hip arthroplasty(THA). Previous report have locked a sufficiently large number of subjects to allow for an analysis of the causes and appropriate treatment of this problem. Methods Between 2015 to 2018, 4,888 primary THA were enrolled. We retrospectively reviewed the records in our Total Joint Registry Database and found that 24 patients (24 hips) had sustained IFAs .24 patients(16 females and 8males)were all treated with posterolateral approach using uncemented components. 20 patients underwent supplemental screw fixation, of which 2 patients were treated with plate fixation. 2 Patients femoral head was used as a graft. In 4 patients, the acetabular component was judged to be stable despite the fracture and no additional treatment was performed All patients were evaluated clinically with Harris Hip Scores (HHS) and radiographically with serial X-rays which follow up for a mean period of 34.0±12.6 months. We evaluated the anatomic location, cause, treatment, and outcome of the fractures. Results The fracture rate associated with uncemented components was 0.49%. In 17(70.8%) of the these patients, the fracture was noted during impaction of the real acetabular component.6 patients with Ankylosing Spondylitis had fracture 4 in anterior wall,1 in anterior column because of patient with hip joint fusion need to pre-osteotomy before dislocation .The HHS score increased from 30.8±9.7 preoperatively to 90.2±4.2 postoperatively. All the latest x-ray showed that the fracture did not move, and there is no translucent line formed in the acetabular cup bone interface.Conclusion IAFs are rare complications of THA, and most commonly occur during the implantation of the acetabular components. It is necessary to prevent the occurrence of fractures as much as possible even if the fractures are found during the operation. It should be noted that patients with ankylosing spondylitis involving hip joints during THA surgery must be careful to prevent IAFs during dislocation and pre-osteotomy.
Comparison of short-term outcomes of anterolateral supine approach and posterolateral approach for primary total hip arthroplasty: a retrospective study