Outcomes of combined hip procedure with dual mobility cup versus osteosynthesis for acetabular fractures in elderly patients: a retrospective observational cohort study of fifty one patients.

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Version: Final published version
License: CC BY 4.0
Serval ID
serval:BIB_B585CE203BB1
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Outcomes of combined hip procedure with dual mobility cup versus osteosynthesis for acetabular fractures in elderly patients: a retrospective observational cohort study of fifty one patients.
Journal
International orthopaedics
Author(s)
Lannes X., Moerenhout K., Duong H.P., Borens O., Steinmetz S.
ISSN
1432-5195 (Electronic)
ISSN-L
0341-2695
Publication state
Published
Issued date
10/2020
Peer-reviewed
Oui
Volume
44
Number
10
Pages
2131-2138
Language
english
Notes
Publication types: Journal Article ; Observational Study
Publication Status: ppublish
Abstract
Acetabular fractures are more and more common in the elderly. Open reduction and internal fixation (ORIF) may lead to poor outcomes and high revision rates. Primary total hip arthroplasty (THA) combined with internal fixation, also known as the combined hip procedure (CHP), associated with dual mobility cup (DM-CHP) could be an efficient procedure in selected elderly patients. The aim of this study is to compare functional and radiological outcomes between ORIF and DM-CHP.
Between 2007 and 2018, 51 patients older than 65 years were surgically treated for acetabular fractures. Twenty-six patients were treated by DM-CHP and 25 by ORIF. Each group was divided into two subgroups regarding a single or combined approach. Hospital stay, surgical time, intraoperative blood loss, and complications were documented. The Harris Hip Score (HHS) was used for measuring the functional outcome. Radiological analysis was used to assess the centre of rotation in the DM-CHP group.
Median surgery time and intra-operative blood loss were higher in DM-CHP than those in ORIF. Early medical complication rate was higher for a combined approach as compared with a single posterior approach in DM-CHP (p = 0.003). Dislocation rate was 7.7% in DM-CHP. Revision rate was higher in ORIF (20% versus 7.7%). HHS was similar in both groups.
DM-CHP leads to similar functional outcomes and less revision than ORIF. This study strengthens the practice of using only the posterior approach for primary THA in the elderly. Dual mobility is a valid therapeutic option for acetabular fractures in elderly patients.
Keywords
Acetabulum/surgery, Aged, Arthroplasty, Replacement, Hip/adverse effects, Fracture Fixation, Internal/adverse effects, Hip Fractures/diagnostic imaging, Hip Fractures/epidemiology, Hip Fractures/surgery, Hip Prosthesis, Humans, Reoperation, Retrospective Studies, Acetabular fractures, Center of rotation, Combined hip procedure, Dual mobility cup, Elderly patient, Open reduction internal fixation
Pubmed
Web of science
Open Access
Yes
Create date
17/08/2020 10:41
Last modification date
05/05/2021 6:36
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