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01-07-2019 | Original Paper

Occult intra-operative periprosthetic fractures of the acetabulum may affect implant survival

Authors: Dietmar Dammerer, David Putzer, Bernhard Glodny, Johannes Petersen, Ferdi Arrich, Martin Krismer, Rainer Biedermann

Published in: International Orthopaedics | Issue 7/2019

Abstract

Purpose

Occult intra-operative periprosthetic acetabular fracture is a seldom-reported complication of primary total hip arthroplasty (THA). It may potentially be associated with cup instability and implant loosening. The present study aimed to investigate clinical consequences of this complication.

Methods

Between 2003 and 2012, a total of 3390 cementless total hip arthroplasties (THA) were performed at our institution. Their medical histories were retrospectively reviewed to identify all patients who received a thin-layer computer tomography (CT) scan of the pelvis including the acetabulum within the first 30 post-operative days. They were evaluated and classified by two radiologists independently with respect to the presence of recent acetabular fractures. All cases with acetabular and periacetabular fractures were included in this study. Electronic medical records were reviewed to assess implant revision. Cup stability was measured with EBRA (Einzel-Bild-Röntgen-Analyse) from plain X-rays.

Results

Periprosthetic fractures of the acetabulum were identified in 58 (50.4%) of 115 selected patients. Fractures close to but not including the acetabulum were identified in 45% (n = 26/58) of the patients, at the superolateral wall in 17% (n = 10/58), at the anterior wall of the acetabulum in 16% (n = 9/58) and in 10% (n = 6/58) each at the medial wall, and at the posterior wall respectively. One out of these 58 fractures could not be classified. Three of a total of six occult medial wall fractures had to be revised, and another two showed a high implant migration. The highest cup migration values however were found after fractures of the superolateral wall. Incomplete column fractures did not influence implant survival.

Conclusion

Central wall acetabular fractures, although unrecognized intra- and post-operatively may impair implant survival after THA.

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Title: Occult intra-operative periprosthetic fractures of the acetabulum may affect implant survival
Authors: Dietmar Dammerer
David Putzer
Bernhard Glodny
Johannes Petersen
Ferdi Arrich
Martin Krismer
Rainer Biedermann
Publication date: 01-07-2019
Publisher: Springer Berlin Heidelberg
Published in: International Orthopaedics / Issue 7/2019
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI: https://doi.org/10.1007/s00264-018-4084-7

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Occult intra-operative periprosthetic fractures of the acetabulum may affect implant survival

Abstract

Purpose

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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