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Early simultaneous bilateral total hip arthroplasty for the management of bilateral acetabular fracture in an elderly patient.

ABSTRACT: Bilateral acetabular fractures in elderly patients due to seizures are very rare and management is a challenge. The standard treatment for acetabular fracture, open reduction with internal fixation, is not recommended for the elderly because of poor bone quality and the need for bed rest. In the acute phase, total hip arthroplasty may be the best treatment option because it allows early mobilization and avoids bed rest complications. We report the case of a 76-year-old man with a bilateral comminuted acetabular fractures and a left fracture dislocation of the shoulder, treated by immediate shoulder arthroplasty and a one-stage bilateral total hip arthroplasty procedure at 3 weeks, with a good result at 1-year follow-up.

SUBMITTER: Tempelaere C

PROVIDER: S-EPMC6588820 | biostudies-other | 2019 Jun

REPOSITORIES: biostudies-other

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Early simultaneous bilateral total hip arthroplasty for the management of bilateral acetabular fracture in an elderly patient.

Tempelaere Christine C Diviné Pierre P Bégué Thierry T

Arthroplasty today 20190503 2

Bilateral acetabular fractures in elderly patients due to seizures are very rare and management is a challenge. The standard treatment for acetabular fracture, open reduction with internal fixation, is not recommended for the elderly because of poor bone quality and the need for bed rest. In the acute phase, total hip arthroplasty may be the best treatment option because it allows early mobilization and avoids bed rest complications. We report the case of a 76-year-old man with a bilateral commi ...[more]

PMID: 31286032

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Project description:PURPOSE:Posttraumatic arthritis (PTA) may develop years after acetabular fracture, hindering joint function and causing significant chronic musculoskeletal pain. Given the delayed onset of PTA, few studies have assessed outcomes of delayed total hip arthroplasty (THA) in acetabular fracture patients. This study systematically reviewed the literature for outcomes of THA in patients with PTA and prior acetabular fracture. METHODS:Pubmed, EMBASE, SCOPUS, and Cochrane library were searched for articles containing the keywords "acetabular", "fracture", "arthroplasty", and "post traumatic arthritis" published between 1995 and August 2017. Studies with less than 10 patients, less than 2 years of follow-up, conference abstracts, and non-English language articles were excluded. Data on patient demographics, surgical characteristics, and outcomes of delayed THA, including implant survival, complications, need for revision, and functional scores, was collected from eligible studies. RESULTS:With 1830 studies were screened and data from 10 studies with 448 patients were included in this review. The median patient age on date of THA was 51.5 years, ranging from 19 to 90 years. The median time from fracture to THA was 37 months, with a range of 27-74 months. Mean follow-up times ranged from 4 to 20 years. The mean Harris hip scores (HHS) improved from 41.5 pre-operatively, to 87.6 post-operatively. The most prevalent postoperative complications were heterotopic ossification (28%-63%), implant loosening (1%-24%), and infection (0%-16%). The minimum 5-year survival of implants ranged from 70% to 100%. Revision rates ranged from 2% to 32%. CONCLUSION:Despite the difficulties associated with performing THA in patients with PTA from previous acetabular fracture (including soft tissue scarring, existing hardware, and acetabular bone loss) and the relatively high complication rates, THA in patients with PTA following prior acetabular fracture leads to significant improvement in pain and function at 10-year follow-up. Further high quality randomized controlled studies are needed to confirm the outcomes after delayed THA in these patients.

Dataset Information

Early simultaneous bilateral total hip arthroplasty for the management of bilateral acetabular fracture in an elderly patient.

Publications

Early simultaneous bilateral total hip arthroplasty for the management of bilateral acetabular fracture in an elderly patient.

Similar Datasets

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