Total hip arthroplasty following acetabular fracture: a clinical and radiographic outcome analysis of 67 patients

  • André BuschEmail author
  • Ulrich Stöckle
  • Anna Schreiner
  • Peter de Zwaart
  • Aljoscha Schäffler
  • Björn Gunnar Ochs
Trauma Surgery



Total hip arthroplasty (THA) is a challenging option for the treatment of posttraumatic arthritis due to acetabular fractures.


The study aimed to determine the short- and mid-term clinical and radiographic results of THA following acetabular fracture. The fracture pattern, the extent of injury and the initial fracture treatment were considered to evaluate the influence of these factors on the clinical-radiographic outcome.


67 patients who received THA for the treatment of posttraumatic osteoarthritis after acetabular fracture between January 2007 and December 2012 were analyzed consecutively. The group consisted of 13 female (19%) and 54 male (81%) patients with a mean age of 59 (25–87) years at the time of THA. The time between acetabular injury and arthroplasty was 107 (1–504) months on average. The all-cause 8-year survival rate was 0.87% (0.76–0.93) and there were 8 revisions, half of them were due to aseptic loosening of the cup. The Harris Hip Score achieved was 75.7 ± 21.3 (26.9–100) points. Prior to THA, heterotopic ossifications were detected in 28% and after THA implantation in 42%.


The decrease of the interval between injury and arthroplasty was associated with increasing patient age (p = 0.001) and surgical treatment of the acetabular fracture (p = 0.04). Complex fracture patterns were accompanied by acetabular bone defects more often than simple patterns (p = 0.03). Overall, arthroplasty due to posttraumatic osteoarthritis after acetabular fracture resulted in decreased overall survival rates and poorer clinical outcome as compared to primary arthroplasty.


Acetabular fracture Posttraumatic arthritis Hip arthroplasty Acetabular defect 


Author contributions

All the authors insured that they had furnished a substantial contribution to the article and that they are in agreement with form and contents of the manuscript.


There is no funding source.

Compliance with ethical standards

Conflict of interest

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. The authors declare that they have no conflict of interest.

Ethics approval and consent to participate

The study was reviewed by the local Ethics Committee and informed consent was obtained from all individual participants included in the study. This article does not contain any studies with human participants or animals performed by any of the authors.

Informed consent

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

Consent to publish

All the patients consented to publish personal data in an anonymized form.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Orthopaedics and Trauma SurgeryUniversity of Duisburg-EssenEssenGermany
  2. 2.BG Trauma Center Tübingen, Eberhard Karls University of TübingenTübingenGermany
  3. 3.Krankenhaus FreudenstadtFreudenstadtGermany

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