Acetabular peri-prosthetic fractures are rare but their incidence is rising due to the increased prevalence of total hip arthroplasty, the increasing life expectancy and the growing functional demand of an ageing population, the incidence of primary total hip arthroplasty is increasing. They are either intra-operative or post-operative and have various aetiologies. Several factors such as implant stability, bone loss, remaining bone stock, fracture pattern, timing, age and co-morbidities of the patients must be considered for adequate treatment. To date, the literature on this subject has been sparse and no universally recognized treatment algorithm exists. Their rarity makes them a little-known entity and their surgical management represents a challenge for most orthopaedic surgeons. This review aims to present an update on epidemiology, the diagnostic work up, existing classification systems, surgical approaches and therapeutic options for acetabular peri-prosthetic fractures.
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http://dx.doi.org/10.3390/medicina58050630 | DOI Listing |
Orthop Traumatol Surg Res
October 2024
Département de Chirurgie Orthopédique du CHU de Caen Unité Inserm Comete 1075, Av. de la Côte de Nacre, 14000 Caen, France.
Background: The concept of dual mobility of total hip arthroplasties (THA) is a revolution in the prevention of dislocations and in the treatment of instability. Its use remains controversial in patients under 60 years old, providing poorer results with first generation cups coated with alumina. This study, carried out on modern dual mobility (DM) cups with a porous bilayer coating, in active patients under 60 years of age aimed to evaluate: (1) the mechanical survival of two latest generation DM THA, with failure defined as revision of acetabular or femoral implants for mechanical loosening, by comparing a tripod cup to a full pressfit cup, (2) to evaluate the complications, (3) to compare the rate of radiographic peri-prosthetic osteolysis between the 2 implants.
View Article and Find Full Text PDFSICOT J
June 2024
National Orthopedic Hospital Cappagh, Cappagh Road, Cappoge, Dublin 11 D11 EV29, Ireland - University College Dublin, School of Medicine, Belfield, Dublin 4, Ireland.
Background: Joint-preserving hip operations can help relieve pain and delay the need for long-term joint arthroplasty. Previous research has not identified procedures that can compromise outcomes following total hip arthroplasty (THA). This meta-analysis aims to evaluate the effect of joint-preserving hip operations on outcomes following subsequent THA.
View Article and Find Full Text PDFMed Eng Phys
April 2024
Department of Mechanical Engineering, Indian Institute of Technology Kharagpur, Kharagpur, 721 302, West Bengal, India. Electronic address:
Generation of polyethylene wear debris and peri‑prosthetic bone resorption have been identified as potential causes of acetabular component loosening in Total Hip Arthroplasty. This study was aimed at optimization of a functionally graded porous acetabular component to minimize peri‑prosthetic bone resorption and polyethylene liner wear. Porosity levels (porosity values at acetabular rim, and dome) and functional gradation exponents (radial and polar) were considered as the design parameters.
View Article and Find Full Text PDFJ Orthop
June 2023
Lancashire Teaching Hospitals NHS Foundation Trust, Trauma and Orthopaedic Surgery, UK.
Aims: Dislocation of a total hip replacement is a serious complication after total hip arthroplasty (THA). Dislocation rates are higher when surgery is performed following trauma. Our study compares post-operative dislocation rates between conventional acetabular bearing (CAB) and dual mobility acetabular bearing (DMB) THA performed for neck of femur fracture alongside post-operative periprosthetic fracture, revision and mortality.
View Article and Find Full Text PDFInt Orthop
July 2023
Hospital Universitario La Paz, Paseo de La Castellana 261, 28046, Madrid, Spain.
Purpose: Instability remains as an unsolved complication after revision total hip arthroplasty (rTHA). Dual mobility (DM) cups have decreased dislocation rate in rTHA; however, there are few clinical studies that evaluate the risk of dislocation after rTHA in patients with high risk of instability.
Methods: Between 2007 and 2019, 95 consecutive rTHA using a DM cup, in 93 patients with instability risk factors were retrospectively reviewed.
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