Long-term follow-up indicated that open reduction and internal fixation was used to successfully treat displaced acetabular fractures in patients without the need for subsequent total hip arthroplasty.
Researchers analyzed 816 acetabular fractures treated with open reduction and internal fixation during a 26-year period. Researchers performed cumulative 2-year to 20 year Kaplan-Meier survivorship analyses of the hips using total hip arthroplasty or hip arthrodesis as the end point. To identify negative predictors, researchers performed univariate and multivariate Cox regression analyses and constructed a nomogram that predicted an individual’s need for early hip arthroplasty.
At 20-year follow-up, the cumulative hip survivorship available was 79%. The results showed cumulative 20-year survivorship was 86% in best case scenarios and 52% in worst case scenarios. Researchers found that nonanatomical fracture reduction, anterior hip dislocation, patient age greater than 40 years, postoperative acetabular roof incongruence and posterior acetabular wall involvement were significant independent negative predictors. Additionally, acetabular impaction, femoral head cartilage lesion, initial articular surface displacement of 20 mm or greater and use of the extended iliofemoral approach also were significant independent negative predictors.