Post traumatic osteoarthris (PTOA)

 

Acetabular trauma and PTOA

 

Trauma Acetabular fractureHip OA trauma

 

Issues

 

Scarring / previous approaches / bleeding

 

Sciatic nerve

 

Prior hardware

 

Infection

 

Instability / dislocation

 

Acetabular bone loss / deformity / discontinuity

 

Types

- central contained defects

- segmental uncontained defects

- pelvic discontinuity

 

Options

- structural bone graft

- trabecular metal augments / buttress

- cage - ilium to ischium

- cup / cage construct

 

Trauma THA post acetabTHA post acetab

Trabecular metal augment

 

Hip OA traumaAcetab traumaTHA post acetab

Structural bone graft

 

Results

 

Stibolt et al Chin J Traumatol 2018

- systematic review of THA for PTOA following acetabular fracture

- 448 patients mean age 51

- mean 3 years post fracture

- high rates of HO, loosening and infection

 

Morison et al CORR 2016

- THA following acetabular fracture in 74 patients

- infection 7%

- dislocation 11%

- HO 43%

 

Alqazzaz et al J Arthroplasty 2024

- THA in acetabular fracture compared to normal indications

- THA in acute acetabular fracture (< 6 months) increased dislocation / revision / fracture

- THA in delayed acetabular fracture (> 6 months) increased dislocation / revision / fracture

- Acute THR has significantly higher rates of dislocation compared to delayed (>6mo) THR