Total hip arthroplasty for failed acetabular fracture: a double-center comparative study on failed proximal femur fracture

Abstract

Purpose This study aimed to compare the clinical and radiological outcomes of patients who underwent total hip arthroplasty (THA) after failed osteosynthesis of acetabular fractures vs. fractures of the proximal femur. Methods This is a retrospective comparative study in two centers. A total of 110 patients who underwent THA after osteosyn thesis of acetabular or proximal femur fractures were categorized into groups: group 1 (53 patients with acetabular fracture) and group 2 (57 patients with proximal femur fracture). The mean follow-up period was 6.3 (range 2?16.5) years. The Harris hip scores (HHSs), complications, radiological results, and Kaplan?Meier survival curves were evaluated. Results The mean preoperative HHSs of 39.4 (group 1) and 41.2 (group 2) were improved to 83.6 and 84.7 at the fnal follow up (p<0.001 and p<0.001, respectively). There were two cases of aseptic cup loosening, two cases of septic cup loosening, two cases of deep infection, two cases of dislocation, two cases of sciatic nerve palsy, and one case of periprosthetic fracture in group 1, and one case of dislocation and two cases of infection in group 2, which showed a statistical diference in com plication rate (p=0.021). Total cup migration was signifcantly higher in group 1 (p=0.015). After a mean follow-up period of 6.3 years, the survival rate was signifcantly lower in group 1 (69.4% vs. 97.1%, p=0.015). Conclusion THA following osteosynthesis of acetabular fracture showed poorer survival, higher complication rate, and higher migration of the acetabular cup than THA following osteosynthesi