Acute total hip arthroplasty for selected displaced acetabular fractures: two to twelve-year results.
Mears DC, Velyvis JH. The Journal of bone and joint surgery. American volume 2002 · PMID 11792772 · doi:10.2106/00004623-200201000-00001
- Question
- Can acute total hip arthroplasty, combined with limited fixation, provide durable results for displaced acetabular fractures with a poor prognosis for ORIF?
- Design
- Single-centre retrospective case series with 2- to 12-year follow-up.
- Patients
- Mainly older patients with displaced acetabular fractures judged likely to fail ORIF (e.g. comminution, impaction, femoral head damage, osteoporosis).
- Intervention
- Acute total hip arthroplasty with cable or limited internal fixation of the columns
- Comparison
- None (case series)
- Primary outcome
- Harris hip score and implant survival
- Key result
- Most patients achieved good or excellent hip scores with a low revision rate for acetabular component loosening, supporting acute arthroplasty as a viable option in selected patients.
- Limitations
- Uncontrolled single-surgeon series without comparison to ORIF or non-operative care.
- Impact on practice
- A foundational paper for the 'fix and replace' approach in older patients, now the subject of ongoing UK randomised trials comparing it with fixation alone.