Total hip arthroplasty, combined with a reinforcement ring and posterior column plating for acetabular fractures in elderly patients : good outcome in 34 patients

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dc.contributor.author Lont, Tonis
dc.contributor.author Nieminen, Jyrki
dc.contributor.author Reito, Aleksi
dc.contributor.author Pakarinen, Toni-Karri
dc.contributor.author Pajamäki, Ilari
dc.contributor.author Eskelinen, Antti
dc.contributor.author Laitinen, Minna K.
dc.date.accessioned 2019-07-19T11:58:01Z
dc.date.available 2019-07-19T11:58:01Z
dc.date.issued 2019-05-04
dc.identifier.citation Lont , T , Nieminen , J , Reito , A , Pakarinen , T-K , Pajamäki , I , Eskelinen , A & Laitinen , M K 2019 , ' Total hip arthroplasty, combined with a reinforcement ring and posterior column plating for acetabular fractures in elderly patients : good outcome in 34 patients ' , Acta Orthopaedica , vol. 90 , no. 3 , pp. 275-280 . https://doi.org/10.1080/17453674.2019.1597325
dc.identifier.other PURE: 125770864
dc.identifier.other PURE UUID: cfd43af1-65b5-445f-947e-f3898b5bfcd3
dc.identifier.other WOS: 000469038600016
dc.identifier.other ORCID: /0000-0002-9975-0121/work/59680311
dc.identifier.uri http://hdl.handle.net/10138/303954
dc.description.abstract Background and purpose Low-energy acetabulum fractures are uncommon, and mostly occur in elderly patients. Determining the optimal operative treatment for such fractures is challenging. Here we investigated whether acutely performed total hip arthroplasty plus posterior column plating (THA) reduced complications and reoperations compared with open reduction and internal fixation (ORIF) in elderly patients with acetabular fractures.Patients and methods We retrospectively reviewed the records of 59 patients, > 55 years of age, with complex acetabular fractures, caused by low-energy trauma, treated between January 2008 and September 2017. Of these patients, 34 underwent acute THA, and 25 ORIF alone. Patient and implant survival were compared between groups using Kaplan-Meier survival analysis and Cox multiple regression. Functional outcomes assessed by Oxford Hip Score (OHS) were compared between the THA patients and those 9 ORIF patients who underwent secondary THA due to posttraumatic hip osteoarthritis (OA) during follow-up.Results Overall patient survival was 90% (95% CI 82-98) at 12 months, and 64% (CI 47-81) at 5 years. Of 25 ORIF patients, 9 required secondary THA due to posttraumatic OA. Large fragments on the weight-bearing acetabular dome upon imaging predicted ORIF failure and secondary THA. The acute THA group and secondary THA group had similar 12-month OHS.Interpretation Acute THA including a reinforcement ring resulted in fewer reoperations than ORIF alone in elderly patients with acetabular fractures. These findings support acute THA as first-line treatment for complex acetabular fractures in elderly patients. en
dc.format.extent 6
dc.language.iso eng
dc.relation.ispartof Acta Orthopaedica
dc.rights cc_by
dc.rights.uri info:eu-repo/semantics/openAccess
dc.subject INTERNAL-FIXATION
dc.subject OPEN REDUCTION
dc.subject SURVIVORSHIP
dc.subject FAILURE
dc.subject JOINT
dc.subject OLDER
dc.subject 3126 Surgery, anesthesiology, intensive care, radiology
dc.title Total hip arthroplasty, combined with a reinforcement ring and posterior column plating for acetabular fractures in elderly patients : good outcome in 34 patients en
dc.type Article
dc.contributor.organization Department of Surgery
dc.contributor.organization Clinicum
dc.contributor.organization I kirurgian klinikka (Töölö)
dc.contributor.organization HUS Musculoskeletal and Plastic Surgery
dc.description.reviewstatus Peer reviewed
dc.relation.doi https://doi.org/10.1080/17453674.2019.1597325
dc.relation.issn 1745-3674
dc.rights.accesslevel openAccess
dc.type.version publishedVersion

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