Delayed Total Hip Arthroplasty for Failed Acetabular Fractures: The Influence of Initial Fracture Management on Outcome After Arthroplasty

Reduced survival for uncemented compared to cemented total hip arthroplasty after operatively treated acetabular fractures

“…This is slightly higher than previously reported by In the present study, we also found a reduced survival for uncemented THAs, with a ten-year survival approaching 58%. This is in contrast with the study published by Gavaskar and colleagues, reporting 95% 10-year survival in a group of 27 patients who received uncemented THA after failed ORIF [7]. Also, Weber [34], showed an overall 10 year survival of 78% (66 patients) and 90 % survival in the uncemented group (20 patients) after an average FU of 9.6 years [34].…”

“…Romness and colleagues reported up to 18.2% revisions after 10 years for cemented cups in their study [31]. More recent reports have almost exclusively focused on the use of uncemented arthroplasties and have described excellent short to midterm results, with survival rates approaching 100% [7,16,30]. Other authors have not confirmed these excellent results, i.e.…”

Bilateral acetabular fractures treated with delayed total hip arthroplasty

“…Mode of failure for delayed THA is commonly cited as acetabular loosening [16]. There are mixed data on whether the blood loss and operative data are higher in the patients who received a THA after ORIF vs nonoperative management of their acetabular fractures [17,18]. More patients in the nonoperative group required reconstruction of their acetabular defects [18].…”

“…There are mixed data on whether the blood loss and operative data are higher in the patients who received a THA after ORIF vs nonoperative management of their acetabular fractures [17,18]. More patients in the nonoperative group required reconstruction of their acetabular defects [18]. These studies reported 88% survival at 11 years and 93% survival at 7 years [17,18].…”

Conversion Total Hip Arthroplasty with a Direct Anterior Approach for Failed Treatment of Acetabular Fractures

“…In comparing AFs treated with or without ORIF, Gavaskar et al noted that initial surgery facilitated later reconstruction, and conversely that 75% of the patients treated without ORIF required further management of major bone defects. 12 Lai et al also noted significant bone defects in 67% of the cases treated conservatively. 13 In our series, two patients required bone grafting in the presence of a nonunion, one who was treated conservatively and one with prior ORIF.…”