Delayed total hip arthroplasty in patients developing osteoarthritis following acetabular fractures

Abstract

Objectives: The aim of this study is to review the short-term results of total hip arthroplasty (THA) for the management of delayed arthritis after acetabular fractures. Methods: This is a retrospective study of operated cases of THA post-acetabular fracture arthritis. Data were collected from computerized hospital records from January 2010 to December 2019. We analyzed post-operative outcomes, which included revision surgery due to any reason, post-operative infection, hip dislocation, sciatic nerve injury, and deep venous thrombosis. In addition, radiographs were evaluated for restoration of the center of rotation (COR), horizontal offset (HO), and vertical offset (VO) by an independent observer. Results: A total of 36 cases (30 males and six females) were included in the study. The average age was 55 years. Road traffic accidents were the most common cause of fractures followed by falls from height. The mean time between the fracture and the development of symptoms of arthritis was 48 months. One THA was complicated by post-operative dislocation. Infection was reported in three cases and sciatic nerve injury occurred in one patient. Heterotopic ossification was seen in four cases and thromboembolism developed in one patient. The COR, HO, and VO showed a normal pattern. Conclusion: THA after acetabular fractures is a complex surgical procedure with relatively high short-term complications. Restoring the hip biomechanics can help in achieving results that are comparable to primary total hip replacement.