Total hip arthroplasty after operatively treated acetabular fracture

Acetabular fractures increase the risk of posttraumatic arthritis and thus the risk of total hip arthroplasty (THA). We previously presented the ten-year results of THA performed for posttraumatic arthritis after an acetabular fracture; we now present the twenty-year outcomes. The original publication included sixty-six patients who underwent THA between 1970 and 1993 for posttraumatic arthritis after open reduction and internal fixation (ORIF) of an acetabular fracture. Clinical outcomes, implant survivorship, radiographic results, and complications were evaluated. A total of thirty-six patients had died. The mean Harris hip score was 80 at the latest follow-up. Nineteen acetabular and/or femoral components had been revised: eleven for aseptic loosening, seven for osteolysis, and one for instability. Twenty-year survivorship of the acetabular component was 71% free from revision for aseptic loosening and 57% free from revision for any reason. THA after ORIF of an acetabular fracture was associated with fair implant survivorship at twenty years after surgery. It is possible that newer implants with improved fixation surfaces and bearing materials may enhance long-term results, as the most common reasons for failure at twenty years were aseptic loosening and osteolysis.

Level of Evidence: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.