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Evaluation of Early and Late Period Arthroplasty Results in the Treatment of Incomplex Acetabular Fractures with Coxarthrosis

Yıl 2022, Cilt: 17 Sayı: 1, 145 - 151, 21.03.2022
https://doi.org/10.17517/ksutfd.910837

Öz

Purpose:
We aimed to compare the clinical results of patients who underwent early and late hip arthroplasty due to complex acetabulum fracture with coxarthrosis and investigate the factors affecting the clinical results.
Method:
Patients who were operated on for acetabular fractures between 2005 and 2017 were retrospectively analysed. Patients with complex fractures according to the Letournel Classification and arthrosis according to the Kellgren-Lawrence radiological criteria were included in the study. Patients were divided in to two groups, post-fracture early period (group 1) and late period (group 2), based on when they underwent arthroplasty. Both groups were compared in terms of Harris hip score, Visual Analogue Scale (VAS), age, arthrosis, operation time, and time to return to daily life.
Result:
It was determined that 20 of the patients included in the study underwent arthroplasty in the early period and 21 in the late period. The mean average Harris score was 71.60 (± 13.5) in those who underwent early arthroplasty and 61.23 (± 2.6) in those who underwent late arthroplasty (p = 0.002). The average VAS score was 1.7 (1–3) in those who underwent early arthroplasty and 2.6 (1–5) in those who underwent late arthroplasty (p= 0.102)
Conclusion:
Early arthroplasty is a safer option with better functional results and lower complication rates than late arthroplasty in patients with complex acetabular fractures with coxarthrosis. In patients with complex acetabular fractures with coxarthrosis, early arthroplasty should be preferred when the surgeon is not sure about early or late arthroplasty.
Keywords: Acetabular fracture, coxarthrosis, total hip replacement.

Kaynakça

  • Laird A, Keating JF. Acetabular Fractures: A 16-Year Prospective Epidemiological Study. J Bone Joint Surg Am 2005; 87(7):969–73.
  • Saterbak AM, Marsh JL, Nepola JV, Brandser EA and T. Turbett. Clinical Failure after Posterior Wall Acetabular Fractures: The Influence of Initial Fracture Patterns. J Orthop Trauma 2000; 14(4):230–37.
  • Chen HW, Zhao GS. Surgical Treatment of Acetabular Posterior Wall Fractures. Zhongogguo Gu Shang 2008; 21(9):674–75.
  • Tannast M, Najibi S, Matta JM. Two to Twenty-Year Survivorship of the Hip in 810 Patients with Operatively Treated Acetabular Fractures. J Bone Joint Surg Am 2012; 94(17):1559–67.
  • Letournel E. Acetabulum Fractures: Classification and Management. Clinic Orthop Relat Res 1980;151(Sept):81–106.
  • FrietmanB, Biert J, Edwards MJR. Patient-Reported Outcome Measures after Surgery for an Acetabular Fracture. Bone Joint J. 2018; 100-B(5):640–45.
  • Mesbahi SAR, Ghaemmaghami A, Ghaemmaghami S, Farhadi P. Outcome after Surgical Management of Acetabular Fractures: A 7-Year Experience. Bull Emerg Trauma .2018; 6(1): 37–44.
  • Negrin LL, Seligson D. Results of 167 Consecutive Cases of Acetabular Fractures Using the Kocher-Langenbeck Approach: A Case Series. J Orthop Surg Res.2017; 12(1):66.
  • Isaacson MJ, Taylor BC, French BG, Poka A. Treatment of Acetabulum Fractures through the Modified Stoppa Approach: Strategies and Outcomes. Clinic Orthop Rel Res.2014; 472(11):3345–52.
  • Mears DC, Velyvis JH. Primary Total Hip Arthroplasty after Acetabular Fracture. Instr Course Lect.2001; 50:335–54.
  • Busch A, Stöckle U, Schreiner A, de Zwaart P, Schäffler A, Ochs BG. Total Hip Arthroplasty Following Acetabular Fracture: A Clinical and Radiographic Outcome Analysis of 67 Patients. Arch Orthop Trauma Surg.2020; 140(3):331–341.
  • Giannoudis PV, Grotz MRW, Papakostidis C, Dinopoulos H. Operative Treatment of Displaced Fractures of the Acetabulum. A Meta-Analysis. J Bone Joint Surg.2005; 87(1): 2–9.
  • Stibolt RD Jr, Harshadkumar AP, Huntley SR, Lehtonen EJ, Shah AB, Naranje SM. Total Hip Arthroplasty for Posttraumatic Osteoarthritis Following Acetabular Fracture: A Systematic Review of Characteristics, Outcomes, and Complications. Chine J Traumatol.2018; 21(3):176–81.
  • Tannast M, Najibi S, Matta JM. Two to Twenty-Year Survivorship of the Hip in 810 Patients with Operatively Treated Acetabular Fractures. J Bone Joint Surg Am 2012; 94(17):1559–67.
  • Enocson A, Blomfeldt R. Acetabular Fractures in the Elderly Treated with a Primary Burch-Schneider Reinforcement Ring, Autologous Bone Graft, and a Total Hip Arthroplasty: A Prospective Study with a 4-Year Follow-Up. J Orthop Trauma 2014; 28(6):330–37.
  • Resch H, Krappinger D, Moroder P, Auffarth A, Blauth M, Becker J. Treatment of Acetabular Fractures in Older Patients-Introduction of a New Implant for Primary Total Hip Arthroplasty. Archiv Orthop Trauma Surg. 2017; 137(4):549–56.
  • Carol L, Caron J, Schmidt AH, Torchia M, Templeman D. Functional Outcomes after Total Hip Arthroplasty for the Acute Management of Acetabular Fractures: 1- to 14-Year Follow-Up. J Orthop Trauma.2015; 29(3):151–59.
  • Herscovici D Jr, Lindvall E, Bolhofner B, Scaduto JM. The Combined Hip Procedure: Open Reduction Internal Fixation Combined with Total Hip Arthroplasty for the Management of Acetabular Fractures in the Elderly. J Orthop Trauma.2010; 24(5):291–96.
  • Sermon A, Broos P, Vanderschot P.Total Hip Replacement for Acetabular Fractures. Results in 121 Patients Operated between 1983 and 2003. Injury.2008; 39(8):914–21.
  • Matta JM. Fractures of the Acetabulum: Accuracy of Reduction and Clinical Resultsin Patients Managed Operatively within Three Weeks after the Injury. J Bone Joint SurgAm 1996; 78(11):1632–45.
  • MouhsineE, Garofalo R, Borens O, Fischer JF, Crevoisier X, Pelet S, et al.. Acute Total Hip Arthroplasty for Acetabular Fractures in the Elderly: 11 Patients Followed for 2 Years. Acta Orthop Scand.2002; 73(6):615–18.

Koksartrozlu Kalçada Gelişen Kompleks Asetabuler Kırığın Tedavisinde Erken ve Geç Dönem Artroplasti Sonuçlarinin Değerlendirilmesi

Yıl 2022, Cilt: 17 Sayı: 1, 145 - 151, 21.03.2022
https://doi.org/10.17517/ksutfd.910837

Öz

ÖZET
Amaç:
Bu çalışmada koksartrozu mevcut olup kompleks asetabulum kırığı nedeniyle erken ve geç kalça artroplastisi yapılan hastaların klinik sonuçlarını karşılaştırmayı ve klinik sonuçları etkileyen faktörleri araştırmayı amaçladık.

Yöntem:
2005 ve 2017 yılları arasında asetabular kırık nedeniyle ameliyat edilen hastalar geriye dönük olarak incelendi. Letournel Sınıflamasına göre kompleks kırıklar ve Kellgren-Lawrence radyolojik kriterlerine göre artrozu olan hastalar, çalışmaya dahil edildi. Hastalar artroplasti yapılma zamanlarına göre kırık sonrası erken dönem (grup 1) ve geç dönem (grup 2) olmak üzere iki gruba ayrıldı. Her iki grup Harris kalça skoru, Visual Analogue Scale (VAS), yaş, artroz, ameliyat süresi ve günlük hayata dönme süresi açısından karşılaştırıldı.
Bulgular:
Çalışmaya alınan hastaların 20'sinin erken dönemde, 21'inin ise geç dönemde artroplasti geçirdiği belirlendi. Ortalama Harris skoru erken artroplasti yapılanlarda 71.60 (± 13.5), geç artroplasti yapılanlarda 61.23 (± 2.6) idi (p = 0.002). Ortalama VAS skoru erken artroplasti yapılanlarda 1.7 (1-3), geç artroplasti yapılanlarda 2.6 (1-5) idi (p = 0,102).
Sonuç:
Erken artroplasti, koksartroz zemininde kompleks asetabular kırığı olan hastalarda geç artroplastiye göre daha iyi fonksiyonel sonuç ve daha düşük komplikasyon oranları ile daha güvenli bir seçenektir. Koksartroz zemininde kompleks asetabular kırığı olan hastalarda, cerrahın erken veya geç artroplasti kararında arada kaldığı durumlarda, erken artroplasti tercih edilmelidir.
Anahtar Kelimeler: Asetabular kırık, koksartroz, total kalça replasmanı

Kaynakça

  • Laird A, Keating JF. Acetabular Fractures: A 16-Year Prospective Epidemiological Study. J Bone Joint Surg Am 2005; 87(7):969–73.
  • Saterbak AM, Marsh JL, Nepola JV, Brandser EA and T. Turbett. Clinical Failure after Posterior Wall Acetabular Fractures: The Influence of Initial Fracture Patterns. J Orthop Trauma 2000; 14(4):230–37.
  • Chen HW, Zhao GS. Surgical Treatment of Acetabular Posterior Wall Fractures. Zhongogguo Gu Shang 2008; 21(9):674–75.
  • Tannast M, Najibi S, Matta JM. Two to Twenty-Year Survivorship of the Hip in 810 Patients with Operatively Treated Acetabular Fractures. J Bone Joint Surg Am 2012; 94(17):1559–67.
  • Letournel E. Acetabulum Fractures: Classification and Management. Clinic Orthop Relat Res 1980;151(Sept):81–106.
  • FrietmanB, Biert J, Edwards MJR. Patient-Reported Outcome Measures after Surgery for an Acetabular Fracture. Bone Joint J. 2018; 100-B(5):640–45.
  • Mesbahi SAR, Ghaemmaghami A, Ghaemmaghami S, Farhadi P. Outcome after Surgical Management of Acetabular Fractures: A 7-Year Experience. Bull Emerg Trauma .2018; 6(1): 37–44.
  • Negrin LL, Seligson D. Results of 167 Consecutive Cases of Acetabular Fractures Using the Kocher-Langenbeck Approach: A Case Series. J Orthop Surg Res.2017; 12(1):66.
  • Isaacson MJ, Taylor BC, French BG, Poka A. Treatment of Acetabulum Fractures through the Modified Stoppa Approach: Strategies and Outcomes. Clinic Orthop Rel Res.2014; 472(11):3345–52.
  • Mears DC, Velyvis JH. Primary Total Hip Arthroplasty after Acetabular Fracture. Instr Course Lect.2001; 50:335–54.
  • Busch A, Stöckle U, Schreiner A, de Zwaart P, Schäffler A, Ochs BG. Total Hip Arthroplasty Following Acetabular Fracture: A Clinical and Radiographic Outcome Analysis of 67 Patients. Arch Orthop Trauma Surg.2020; 140(3):331–341.
  • Giannoudis PV, Grotz MRW, Papakostidis C, Dinopoulos H. Operative Treatment of Displaced Fractures of the Acetabulum. A Meta-Analysis. J Bone Joint Surg.2005; 87(1): 2–9.
  • Stibolt RD Jr, Harshadkumar AP, Huntley SR, Lehtonen EJ, Shah AB, Naranje SM. Total Hip Arthroplasty for Posttraumatic Osteoarthritis Following Acetabular Fracture: A Systematic Review of Characteristics, Outcomes, and Complications. Chine J Traumatol.2018; 21(3):176–81.
  • Tannast M, Najibi S, Matta JM. Two to Twenty-Year Survivorship of the Hip in 810 Patients with Operatively Treated Acetabular Fractures. J Bone Joint Surg Am 2012; 94(17):1559–67.
  • Enocson A, Blomfeldt R. Acetabular Fractures in the Elderly Treated with a Primary Burch-Schneider Reinforcement Ring, Autologous Bone Graft, and a Total Hip Arthroplasty: A Prospective Study with a 4-Year Follow-Up. J Orthop Trauma 2014; 28(6):330–37.
  • Resch H, Krappinger D, Moroder P, Auffarth A, Blauth M, Becker J. Treatment of Acetabular Fractures in Older Patients-Introduction of a New Implant for Primary Total Hip Arthroplasty. Archiv Orthop Trauma Surg. 2017; 137(4):549–56.
  • Carol L, Caron J, Schmidt AH, Torchia M, Templeman D. Functional Outcomes after Total Hip Arthroplasty for the Acute Management of Acetabular Fractures: 1- to 14-Year Follow-Up. J Orthop Trauma.2015; 29(3):151–59.
  • Herscovici D Jr, Lindvall E, Bolhofner B, Scaduto JM. The Combined Hip Procedure: Open Reduction Internal Fixation Combined with Total Hip Arthroplasty for the Management of Acetabular Fractures in the Elderly. J Orthop Trauma.2010; 24(5):291–96.
  • Sermon A, Broos P, Vanderschot P.Total Hip Replacement for Acetabular Fractures. Results in 121 Patients Operated between 1983 and 2003. Injury.2008; 39(8):914–21.
  • Matta JM. Fractures of the Acetabulum: Accuracy of Reduction and Clinical Resultsin Patients Managed Operatively within Three Weeks after the Injury. J Bone Joint SurgAm 1996; 78(11):1632–45.
  • MouhsineE, Garofalo R, Borens O, Fischer JF, Crevoisier X, Pelet S, et al.. Acute Total Hip Arthroplasty for Acetabular Fractures in the Elderly: 11 Patients Followed for 2 Years. Acta Orthop Scand.2002; 73(6):615–18.
Toplam 21 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Sağlık Kurumları Yönetimi
Bölüm Araştırma Makaleleri
Yazarlar

Vahit Yıldız 0000-0003-3639-0912

Ali Şişman 0000-0001-8461-3258

Caner Poyraz 0000-0002-3169-2455

Halil Yıldırım Bu kişi benim 0000-0002-6333-8303

Kadri Yıldız 0000-0002-8164-7687

Sevki Oner Savk 0000-0003-1647-7260

Yayımlanma Tarihi 21 Mart 2022
Gönderilme Tarihi 6 Nisan 2021
Kabul Tarihi 24 Nisan 2021
Yayımlandığı Sayı Yıl 2022 Cilt: 17 Sayı: 1

Kaynak Göster

AMA Yıldız V, Şişman A, Poyraz C, Yıldırım H, Yıldız K, Savk SO. Evaluation of Early and Late Period Arthroplasty Results in the Treatment of Incomplex Acetabular Fractures with Coxarthrosis. KSÜ Tıp Fak Der. Mart 2022;17(1):145-151. doi:10.17517/ksutfd.910837