This Mayo Clinic retrospective study evaluated 66 THAs performed for post-traumatic osteoarthrosis after prior acetabular fracture ORIF. It asks: how durable are these implants, and which factors predict failure?
When your patient with prior acetabular ORIF develops post-traumatic arthritis, their THA is not a routine case — and this paper quantifies exactly why.
The single most important preoperative variable is acetabular bone stock. Type III deficiency (combined segmental and cavitary loss per D'Antonio) drives 10-year cup survival down to 27%. Assess bone loss on preoperative CT, counsel the patient accordingly, and plan for possible bone grafting.
For fixation, the data favor cementless acetabular components. Every cup that failed in this series was cemented; sclerotic post-traumatic bone is a poor cement substrate, much like the revision THA setting.
Young age and higher body weight compound the risk. A 35-year-old laborer with type III deficiency sits at the worst intersection of every risk factor in this paper. That conversation about realistic implant longevity needs to happen before the OR.
This Mayo Clinic retrospective study evaluated 66 THAs performed for post-traumatic osteoarthrosis after prior acetabular fracture ORIF. It asks: how durable are these implants, and which factors predict failure?
When your patient with prior acetabular ORIF develops post-traumatic arthritis, their THA is not a routine case — and this paper quantifies exactly why.
The single most important preoperative variable is acetabular bone stock. Type III deficiency (combined segmental and cavitary loss per D'Antonio) drives 10-year cup survival down to 27%. Assess bone loss on preoperative CT, counsel the patient accordingly, and plan for possible bone grafting.
For fixation, the data favor cementless acetabular components. Every cup that failed in this series was cemented; sclerotic post-traumatic bone is a poor cement substrate, much like the revision THA setting.
Young age and higher body weight compound the risk. A 35-year-old laborer with type III deficiency sits at the worst intersection of every risk factor in this paper. That conversation about realistic implant longevity needs to happen before the OR.