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01-09-2019 | Original Paper

Predictors for secondary hip osteoarthritis after acetabular fractures—a pelvic registry study

Authors: Mika F. Rollmann, Jörg H. Holstein, Tim Pohlemann, Steven C. Herath, Tina Histing, Benedikt J. Braun, Hagen Schmal, Guy Putzeys, Ivan Marintschev, Emin Aghayev

Published in: International Orthopaedics | Issue 9/2019

Abstract

Purpose

Secondary hip osteoarthritis after acetabular fractures requiring total arthroplasty (THA) poses a huge burden on the affected patients as well as health systems. The present study aimed to assess risk factors associated with THA after acetabular fractures based on the data from the German Pelvic Trauma Registry.

Methods

Retrospective analysis of 678 acetabular fracture cases without concomitant pelvic ring fracture treated and followed-up between January 2004 and May 2015 at six large trauma centres. Multivariate Cox regression analysis was performed assessing the association of patient/treatment characteristics with THA likelihood at an average follow-up of 2.7 years (range 0.4–9.5 years; SD 1.8 years).

Results

Overall, the rate of secondary osteoarthritis was 19.8%. The likelihood for THA increased with 6% per age year (95% CI 1.04–1.09) and with 21% per millimetre subluxation (95%CI 1.09–1.33). This likelihood was 3.54 (95% CI 1.77–7.08) and 3.68 times (95% CI 1.87–7.47) higher if the posterior wall was involved and a contusion and/or impaction of the femoral head was present. Other covariates (sex, ISS, trauma type, AO/OTA and Letournel classification, initial displacement, surgical approach, intra-articular fragments, contusion and/or impaction to the acetabulum, reduction, intervention type, duration of surgery, soft tissue damage, residual fracture step/gap, and prevention of heterotopic ossifications) were not significantly associated (p > 0.15).

Conclusions

Twenty percent of patients with acetabular fractures require THA. The associated risk factors are patient age, femoral head lesion/subluxation, and involvement of the posterior wall. The identified risk factors support previous research and should be minded when treatment of acetabular fractures is planned.

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Title: Predictors for secondary hip osteoarthritis after acetabular fractures—a pelvic registry study
Authors: Mika F. Rollmann
Jörg H. Holstein
Tim Pohlemann
Steven C. Herath
Tina Histing
Benedikt J. Braun
Hagen Schmal
Guy Putzeys
Ivan Marintschev
Emin Aghayev
Publication date: 01-09-2019
Publisher: Springer Berlin Heidelberg
Published in: International Orthopaedics / Issue 9/2019
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI: https://doi.org/10.1007/s00264-018-4169-3

At a glance: The STEP trials

Springer Medicine

Predictors for secondary hip osteoarthritis after acetabular fractures—a pelvic registry study

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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