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International Orthopaedics

, Volume 43, Issue 10, pp 2383–2389 | Cite as

Outcomes of acetabular fractures in the elderly: a five year retrospective study of twenty seven patients with primary total hip replacement

  • Jean-Charles GiuntaEmail author
  • Camille Tronc
  • Gael Kerschbaumer
  • Michel Milaire
  • Sébastien Ruatti
  • Jerôme Tonetti
  • Mehdi Boudissa
Original Paper

Abstract

Purposes

Open reduction and internal fixation (ORIF) in osteoporotic acetabular fractures is quite difficult with high risk of implant failure. Total hip arthroplasty (THA) may be an effective option for treating acetabular fractures in appropriately selected patients, with immediate full weightbearing. The aim of the study was to evaluate the functional outcomes of primary THA for acetabular fractures in elderly patients.

Methods

Between 2010 and 2015, 27 elderly patients operated for acetabular fractures by primary THA were included. The surgical technique associated plate stabilization of both acetabular columns with THA using an acetabular reinforcement cross-plate. Mean age was 68.5 years (57–84) and mean ASA was 2 (1–3). The mean follow-up was four years.

Results

The mean Harris score was 70.4 ± 23 (24–90), and the mean Postel-Merle Aubigné (PMA) score was 14.3 ± 4 (7–18). For 17 patients with rank of pre-operative Devane 4, the post-operative rank was unchanged (p < 0.05). Twenty patients (74%) were satisfied by the surgical treatment. Twenty post-operative complications (74%) were found. Two patients died during follow-up (7%).

Conclusions

Primary THA for acetabular fracture in the elderly population might be a good therapeutic option that allows return to the previous daily life activity. Three patients (11%) became bedridden, and four patient’s skiers (15%) returned to skiing. However, this surgery is difficult and selection of elderly patients, i.e., with acetabular fractures who are expected to get a poor result with ORIF, i.e., fracture patterns with posterior wall lesion and marginal impaction, for primary THA in an experienced centre provides satisfactory clinical results.

Keywords

Primary total hip replacement Acetabular fractures Elderly patients Harris score Osteoporotic fracture 

Notes

Acknowledgments

We thank Prof. Jerome Tonetti for providing study data and assisting with the manuscript. Furthermore, we would like to thank Mehdi Boudissa and Camille Tronc for their assistance during the clinical study.

Funding

There is no funding source.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This study was approved by our local ethic committee.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Copyright information

© SICOT aisbl 2018

Authors and Affiliations

  1. 1.Centre Hospitalier Universitaire Grenoble AlpesLa TroncheFrance

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