Matta's 1996 prospective cohort of 262 displaced acetabular fractures operatively treated by a single surgeon asks: what is the relationship between quality of surgical reduction and long-term clinical outcome? All fractures were classified by Letournel-Judet criteria and graded at mean 6-year follow-up using a modified Merle d'Aubigné-Postel system. It remains the largest single-surgeon series establishing the reduction quality threshold that defines success in acetabular surgery.
The concept of a 'satisfactory' 2–3 mm reduction persisted in acetabular surgery until this paper. Earlier reports — including Matta's own smaller series. Suggested imperfect and anatomical reductions had similar outcomes. With more patients and longer follow-up, the data changed: imperfect and poor reductions are equivalent, and anatomical is the only threshold that matters.
When you assess reduction intraoperatively or review postoperative imaging, the standard is ≤1 mm. Documenting '2 mm, satisfactory' is not supported by the data. It performs no better than a frankly poor reduction.
For approach selection, the ectopic bone rates are directly applicable: reserve the extended iliofemoral approach only when anatomical reduction is truly unachievable through Kocher-Langenbeck or ilioinguinal, because the 20% rate of clinically significant ectopic bone represents major preventable morbidity.
When counseling patients preoperatively, femoral head cartilage or bone damage found on CT or at operation is the one injury characteristic that independently worsens prognosis. Worth flagging before surgery if imaging suggests femoral head impaction or chondral injury.
Matta's 1996 prospective cohort of 262 displaced acetabular fractures operatively treated by a single surgeon asks: what is the relationship between quality of surgical reduction and long-term clinical outcome? All fractures were classified by Letournel-Judet criteria and graded at mean 6-year follow-up using a modified Merle d'Aubigné-Postel system. It remains the largest single-surgeon series establishing the reduction quality threshold that defines success in acetabular surgery.
The concept of a 'satisfactory' 2–3 mm reduction persisted in acetabular surgery until this paper. Earlier reports — including Matta's own smaller series. Suggested imperfect and anatomical reductions had similar outcomes. With more patients and longer follow-up, the data changed: imperfect and poor reductions are equivalent, and anatomical is the only threshold that matters.
When you assess reduction intraoperatively or review postoperative imaging, the standard is ≤1 mm. Documenting '2 mm, satisfactory' is not supported by the data. It performs no better than a frankly poor reduction.
For approach selection, the ectopic bone rates are directly applicable: reserve the extended iliofemoral approach only when anatomical reduction is truly unachievable through Kocher-Langenbeck or ilioinguinal, because the 20% rate of clinically significant ectopic bone represents major preventable morbidity.
When counseling patients preoperatively, femoral head cartilage or bone damage found on CT or at operation is the one injury characteristic that independently worsens prognosis. Worth flagging before surgery if imaging suggests femoral head impaction or chondral injury.