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Total hip arthroplasty for posttraumatic osteoarthritis secondary to acetabular fracture: An evidence based on 1,284 patients from 1970 to 2018. | LitMetric

AI Article Synopsis

  • - A study aimed to evaluate the effectiveness of total hip arthroplasty (THA) for patients with posttraumatic osteoarthritis (PTOA) following acetabular fractures (AF) using meta-analyses of existing clinical evidence.
  • - Researchers analyzed 3,125 studies, ultimately including 31 studies with 1,284 patients, finding an overall implant survival rate of 88% and significant improvement in hip function (43.25 mean difference) after THA.
  • - The study concluded that THA substantially improves symptoms and functionality in patients with PTOA due to AF, with acceptable survival rates of implants even after long-term follow-up (up to 83% at ≥15 years).

Article Abstract

Background: Posttraumatic osteoarthritis (PTOA) can be a crippling sequela of acetabular fracture (AF), and total hip arthroplasty (THA) is often necessary to alleviate the clinical progression of symptoms. The purpose of this study was to summarize the existing clinical evidence concerning the surgical management of AF with THA through meta-analyses.

Methods: Databases were searched for articles published between 1995 and January 2022 that contained the keywords "acetabular," "fracture," "arthroplasty," and "osteoarthritis." Our study was registered in PROSPERO under number CRD42022314997.

Results: We screened 3,125 studies and included data from 31 studies with 1,284 patients. The median patient age at the time of THA was 52 years and ranged from 19 to 94 years. The pooled overall survival rate was 88% [86%-90%, 95% confidence interval (CI)] and could reach 83% at ≥15-year follow-up. For the Harris Hip Score, we pooled 22 studies with an overall mean difference of 43.25 (40.40-46.10, 95% CI;  < 0.001), indicating a large clinical effect. The pooled complications (incidence rates) across studies were: heterotopic ossification (22.53%), implant dislocation (4.66%), implant infection (3.44%), and iatrogenic nerve injury (1.07%).

Conclusion: THA in patients with PTOA following AF leads to significant improvement in symptoms and function at ≥15-year follow-up. Survival rates of implants free from re-operation or revision after THA decreased with follow-up time and could still reach 83% at ≥15-year follow-up. THA might be an effective therapeutic method for patients with PTOA due to AF.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9684333PMC
http://dx.doi.org/10.3389/fsurg.2022.953976DOI Listing

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