Tannast, J Bone Joint Surg Am 2012 - Two to Twenty-Year Survivorship of the Hip in 810 Patients with Operatively Treated Acetabular Fractures

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Two to Twenty-Year Survivorship of the Hip in 810 Patients with Operatively Treated Acetabular Fractures

Tannast, Matta, et al.·J Bone Joint Surg Am·2012·429 citations·Retrospective cohort

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Background

The aims of the study were (1) to determine the cumulative 2 to 20-year survivorship of the hip after open reduction and internal fixation of displaced acetabular fractures, (2) to identify factors predicting conversion to total hip arthroplasty or hip arthrodesis, and (3) to create a predictive model that calculates an individual's probability of early need for total hip arthroplasty or hip arthrodesis.

Methods

816 acetabular fractures treated with open reduction and internal fixation by one surgeon over a 26-year period were analyzed.
Cumulative 2 to 20-year Kaplan-Meier survivorship analyses of the hip, including best and worst-case scenarios, were performed with total hip arthroplasty or hip arthrodesis as the end point.
Univariate and multivariate Cox regression analyses were performed to identify negative predictors, which were then used to construct a nomogram for predicting an individual's probability of needing an early total hip arthroplasty.

Results

The cumulative 20-year survivorship of the 816 hips available for follow-up was 79% at 20 years.
The best and worst-case scenarios corresponded to cumulative 20-year survivorship of 86% and 52%, respectively.
Significant independent negative predictors were nonanatomical fracture reduction, an age of more than 40 years, anterior hip dislocation, postoperative incongruence of the acetabular roof, involvement of the posterior acetabular wall, acetabular impaction, a femoral head cartilage lesion, initial displacement of the articular surface of ≥ 20 mm, and utilization of the extended iliofemoral approach.

Conclusions

Open reduction and internal fixation of displaced acetabular fractures was able to successfully prevent the need for subsequent total hip arthroplasty within 20 years in 79% of the patients. The results represent benchmark comparative data for any future and past studies on the outcome of surgical fixation of acetabular fractures.

Copyright remains with the authors and publisher.

Two to Twenty-Year Survivorship of the Hip in 810 Patients with Operatively Treated Acetabular Fractures.

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Two to Twenty-Year Survivorship of the Hip in 810 Patients with Operatively Treated Acetabular Fractures

Tannast, Matta, et al.·J Bone Joint Surg Am·2012·429 citations·Retrospective cohort

|

Background

The aims of the study were (1) to determine the cumulative 2 to 20-year survivorship of the hip after open reduction and internal fixation of displaced acetabular fractures, (2) to identify factors predicting conversion to total hip arthroplasty or hip arthrodesis, and (3) to create a predictive model that calculates an individual's probability of early need for total hip arthroplasty or hip arthrodesis.

Methods

816 acetabular fractures treated with open reduction and internal fixation by one surgeon over a 26-year period were analyzed.
Cumulative 2 to 20-year Kaplan-Meier survivorship analyses of the hip, including best and worst-case scenarios, were performed with total hip arthroplasty or hip arthrodesis as the end point.
Univariate and multivariate Cox regression analyses were performed to identify negative predictors, which were then used to construct a nomogram for predicting an individual's probability of needing an early total hip arthroplasty.

Results

The cumulative 20-year survivorship of the 816 hips available for follow-up was 79% at 20 years.
The best and worst-case scenarios corresponded to cumulative 20-year survivorship of 86% and 52%, respectively.
Significant independent negative predictors were nonanatomical fracture reduction, an age of more than 40 years, anterior hip dislocation, postoperative incongruence of the acetabular roof, involvement of the posterior acetabular wall, acetabular impaction, a femoral head cartilage lesion, initial displacement of the articular surface of ≥ 20 mm, and utilization of the extended iliofemoral approach.

Conclusions

Open reduction and internal fixation of displaced acetabular fractures was able to successfully prevent the need for subsequent total hip arthroplasty within 20 years in 79% of the patients. The results represent benchmark comparative data for any future and past studies on the outcome of surgical fixation of acetabular fractures.

Copyright remains with the authors and publisher.

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