Midterm Results of Uncemented Acetabular Reconstruction for Posttraumatic Arthritis Secondary to Acetabular Fracture

Porous Metal Acetabular Components Have a Low Rate of Mechanical Failure in THA After Operatively Treated Acetabular Fracture

“…Infection and further compromised bone stock are especially a concern in those patients who have previously undergone open reduction and internal fixation (ORIF). More recent reports on the use of uncemented acetabular components have demonstrated a lower frequency of aseptic loosening [1,2,16,17,21,28], and a recent study by Kamath et al [14] confirmed these results in a small number of patients treated with THA using a porous metal cup after acetabular fracture. However, the majority of acetabular fractures in these studies had initially been managed nonoperatively, and thus the degree of bone loss and the environment for early osseointegration of the uncemented acetabular component to the host pelvis may not be comparable to the acetabulum that has already undergone ORIF [27].…”

“…Acetabular reconstruction in the setting of prior acetabular fracture has historically been met with high rates of aseptic loosening, particularly in the era of cemented acetabular fixation [22,27]. More recent reports with uncemented acetabular fixation have demonstrated reduced rates of mechanical failure [1,2,16,17,21,28]. Despite these improvements, most of these reports included patients who were managed both with ORIF and nonoperatively at the time of acetabular fracture.…”

Quadrilateral plate fractures of the acetabulum: An update

“…61,83,84 Delayed hip arthroplasty following acetabular fractures with central dislocation may follow either conservative, 56,85 or operative fracture treatment. 13,63,[86][87][88] Several authors have suggested that open reduction and internal fixation of fractures may preserve bone stock and allow easier THA if required at a later date, 13,63,[86][87][88] whereas others feel that it is not necessary and complicates later arthroplasty due to dense scar tissue, heterotopic ossification, the need for hardware removal in many instances, increased operative time, blood loss, transfusion requirements and potential occult infection. 15,16,63,81,84,[87][88][89][90] The results of THA for all types of acetabular fractures have been historically inferior to those performed for primary osteoarthritis due to higher rates of aseptic loosening.…”

“…13,63,[86][87][88] Several authors have suggested that open reduction and internal fixation of fractures may preserve bone stock and allow easier THA if required at a later date, 13,63,[86][87][88] whereas others feel that it is not necessary and complicates later arthroplasty due to dense scar tissue, heterotopic ossification, the need for hardware removal in many instances, increased operative time, blood loss, transfusion requirements and potential occult infection. 15,16,63,81,84,[87][88][89][90] The results of THA for all types of acetabular fractures have been historically inferior to those performed for primary osteoarthritis due to higher rates of aseptic loosening. 14,86,87,90,91 This has been attributed to residual acetabular deformity and bony deficiency, which often require bone grafting and can make anatomic restoration of the hip centre difficult; younger age and weight over 80 kg.…”

“…14,86,87,90,91 This has been attributed to residual acetabular deformity and bony deficiency, which often require bone grafting and can make anatomic restoration of the hip centre difficult; younger age and weight over 80 kg. 63,[86][87][88][89][90][91][92] Using cemented acetabular cups Romness and Lewallen 86 reported radiographic loosening in 52.9%, which was symptomatic in 27.5% and progressed to revision in 13.7% at 7.5 years. Use of uncemented acetabular components has provided improved results with lower rates of loosening and satisfactory outcomes with midterm survival rates of 97%.…”