• Eur J Trauma Emerg Surg · Sep 2024

    Intraoperative Acetabular Fractures in Primary Total Hip Arthroplasty Management and Functional Outcomes.

    • Albert Fontanellas-Fes, Xavier Lizano-Díez, Alfonso León-García, Albert Pardo I Pol, Santos Martínez-Diaz, Vito Andriola, and Fernando Marqués-López.
    • Department of Orthopaedic Surgery and Traumatology, Parc de Salut Mar- Hospital del Mar- Universitat Pompeu Fabra (UPF), Passeig Marítim, 25, Barcelona, Spain. afontanellas@psmar.cat.
    • Eur J Trauma Emerg Surg. 2024 Sep 3.

    PurposeIntraoperative acetabular fracture (IAF) is a non-common complication of primary total hip arthroplasty (THA). Despite the prevalence of intraoperative periprosthetic fractures are increasing, little has been written about this type of fracture. The main objective is to analyze possible risk factors, treatment options and functional outcomes associated with IAF.MethodsBetween 2006 and 2020, 4 senior arthroplasty surgeons performed 5540 uncemented primary THA. We reviewed our Total Joint Registry and found 18 cases with an IAF. We analyzed demographic factors, medical history, preoperative diagnose, acetabular cups designs, anatomic location of the fracture, treatment, associated complications and functional outcomes. The minimum duration of follow-up was 12 months.ResultsThe prevalence of an IAF was 0,3%. All the acetabular cups were hemispherical modular. The most frequent acetabular cup associated with an IAF was the CSF Plus (JRI). In two cases the acetabular components were judged to be stable and no additional treatment was done. In the other sixteen patients, various surgical procedures were carried out. Almost 30% of patients that sustained an IAF had some complication during their follow up. Moreover, poor functionality outcomes were obtained (12.1 ± 4.1). in the final follow up accordance to Postel Merle d'Aubingé score.ConclusionAlthough IAF is a rare complication of THA, maintaining a high index of suspicion is important as they can be difficult to identify. Still with an adequate early treatment they have poor functionality and high risk of associated complications.© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.

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