Patients undergoing surgical hip dislocation for the treatment of acetabular fractures show favourable long-term outcome

• DOI: 10.1302/0301-620x.99b4.37681
• Publication Date: 2017-04-06T10:43:53Z
• Authors: P. C. Haefeli; G. S. Marecek; M. J. B. Keel; K. A. Siebenrock; M. Tannast
• Keywords: Adult; Aged, 80 and over; Male; Adolescent; Arthroplasty, Replacement, Hip; Acetabulum; Kaplan-Meier Estimate; Middle Aged; Prognosis; Osteoarthritis, Hip; Fracture Fixation, Internal; Fractures, Bone; Young Adult; 03 medical and health sciences; Treatment Outcome; 0302 clinical medicine; Humans; Female; Hip Joint; Aged; Follow-Up Studies; Retrospective Studies

Aims The aims of this study were to determine the cumulative ten-year survivorship of hips treated for acetabular fractures using surgical hip dislocation and to identify factors predictive of an unfavourable outcome. Patients and Methods We followed up 60 consecutive patients (61 hips; mean age 36.3 years, standard deviation (sd) 15) who underwent open reduction and internal fixation for a displaced fracture of the acetabulum (24 posterior wall, 18 transverse and posterior wall, ten transverse, and nine others) with a mean follow-up of 12.4 years (sd 3). Results Clinical grading was assessed using the modified Merle d’Aubigné score. Radiographic osteoarthritis was graded according to Matta. Kaplan-Meier survivorship and a univariate Cox-regression analysis were carried out using the following endpoints: total hip arthroplasty, a Merle d’Aubigné score of < 15 and/or progression of osteoarthritis. Conclusion The ten-year cumulative survivorship was 82% (95% confidence interval 71 to 92). Predictors for the defined endpoints were femoral chondral lesions, marginal impaction, duration of surgery, and age of patient. Cite this article: Bone Joint J 2017;99-B:508–15.