Summary: Associated both-column acetabular fractures with posterior wall involvement do not appear to confer worse clinical outcomes for patients than those without especially as it relates to ipsilateral joint replacement.

Background

Acetabular fractures are debilitating injuries with treatment and morbidity profiles largely associated with classification schema described by Judet and Letournel. Patterns often exist outside this schema however including an Associated Both-Column acetabular fracture (ABCAF, OTA/AO 62C) with a concomitant Posterior Wall (PW) fracture. This fracture pattern is thought to create significant hip instability; however, little investigation has been done to determine outcomes following surgical repair of these injuries in comparison to ABCAFs with no PW involvement.

Objectives

The objective of this study was to compare ABCAF injuries with and without PW involvement primarily regarding subsequent conversion to total hip arthroplasty (THA) to determine if PW involvement is an indicator for poor outcomes.

Design and Methods

This review utilized study groups determined from a database of all 72 ABCAFs in 72 patients treated with open reduction and internal fixation between 2010 and 2017 at two Level I trauma centers. The presence of an ipsilateral PW fracture was determined radiographically yielding a control group (-PW) of 47 patients and a study group (+PW) of 25 patients. 26 (59%) control and 18 (41%) study patients were included for final analysis through achievement of 12-months of follow up and/or subsequent conversion to a THA. Patients who received a THA as their index procedure (n=5) were excluded. Demographic, injury, treatment, and post-operative course information was collected retrospectively via a chart review for these patients. Unpaired t-tests were used to compare study and control groups across all factors. A Kaplan-Meier curve was applied to compare survivorship of control and study groups.

Results

Of the 44 patients included, 7 (15.9%) received a subsequent THA although no difference in the rate of conversion between study (n=4, 22.2%) and control (n=3, 11.1%) groups was seen (p=0.42). Results from the Kaplan-Meier curve also indicated no difference in survivorship between study groups (p=0.35).

No differences between groups were observed across other treatment and post-operative outcomes, including length of surgery (p=0.57), complication rate (p=0.76), and post-operative pain (p=0.14). It should be noted that complication rates were high overall for both study groups, with 7 (38.9%) +PW and 8 (30.1%) -PW patients experiencing a complication. The average age of all included patients was 50.5 years, with no difference between groups (p=0.51). No differences in % male (p=1.00), average Charlson Comorbidity Index (p=0.98), or mechanism of injury (p=0.72) were observed.

Conclusion

ABCAFs with PW involvement do not appear to confer worse clinical outcomes for patients than those without especially as it relates to ipsilateral joint replacement. This information should aid in treatment planning following these injuries.

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Are Image-Guided Intraarticular Hip Injections Associated with an Increased Risk of Infection Following Hip Arthroscopy? Abstract Presentation 5 minutes Nathan Varady, MD, MBA, UNITED STATES Troy Amen, BA, UNITED STATES Ahab Chopra, BA, UNITED STATES Paul F Abraham, BS, UNITED STATES Michael Peter Kucharik, BS, UNITED STATES Christopher T Eberlin, BS, UNITED STATES David Freccero, MD, UNITED STATES Eric L. Smith, MD, UNITED STATES Scott D Martin, MD, UNITED STATES
Endoscopic Iliotibial Band Release During Hip Arthroscopy For Femoroacetabular Impingement Syndrome And External Snapping Hip Had Better Patient-Reported Outcomes: A Retrospective Comparative Study Abstract Presentation 5 minutes Chunbao Li, MD, PhD, CHINA Shanxing Zhang, MD, CHINA
Comparison Of Pull-Out Strength Following Ligamentum Teres Reconstruction In The Hip: Peek Corkscrew Suture Anchor Versus Cortical Button Fixation: A Cadaveric Study. Abstract Presentation 5 minutes Ajay C. Lall, MD, MS, FAAOS, UNITED STATES Hari Krishna Ankem, MD, UNITED STATES Samantha Diulus, BS, UNITED STATES Benjamin G. Domb, MD, UNITED STATES
Segmental Labral Reconstruction With A Polyurethane Scaffold: Assessment Of Femoro-Acetabular Contact Mechanics Abstract Presentation 5 minutes Bruno Capurro, MD, PhD., SPAIN Marc Tey, MD, PhD., SPAIN Francisco Reina, MD, PhD, SPAIN Anna Carrera, MD, PhD., SPAIN Mauricio Gidi, MD, SPAIN Joan Carles Monllau, MD, PhD, Prof., SPAIN
Biomechanical Assessment of the Risk of Hip Injury During A 2,000m Ergometer Row Test Abstract Presentation 5 minutes Jordan Page Ankersen, BS, UNITED STATES Stephanie S Gardner, MD, UNITED STATES Bradley S Lambert, PhD, UNITED STATES Joshua D Harris, MD, UNITED STATES Patrick C. McCulloch, MD, UNITED STATES Michael R Moreno, PhD, UNITED STATES Shari Liberman, MD, UNITED STATES
Results After Arthroscopic Treatment Of Iliopsoas Impingement After Total Hip Arthroplasty ePoster Presentation Wolfgang Miehlke, MD, GERMANY Christian Sobau, MD, GERMANY Alexander Zimmerer, MD, GERMANY
A Comparison Of Perioperative Outcomes Between Patients Who Underwent Hip Arthroscopy With And Without The Pericapsular Nerve Group Block ePoster Presentation Albert A Yusupov, MD, UNITED STATES Iciar M Davila Castrodad, MD, UNITED STATES Matthew J. Kraeutler, MD, UNITED STATES Christopher J Mazzei, MD, UNITED STATES Stephen A. Hunt, MD Kimberly V Tucker, MD, UNITED STATES Anthony Scillia, UNITED STATES Patrick A Armstrong, MD, UNITED STATES Mathew S Chow, MD, UNITED STATES Richard A Stennett, MD, UNITED STATES James C Wittig, MD
Hip Disorders in Bull Riders: Clinical Observations and Outcomes of Arthroscopy Abstract Presentation 6 minutes J.W. Thomas Byrd, MD, UNITED STATES Kay S. Jones, MSN, RN, UNITED STATES
Mortality After Hip Or Knee Arthroplasty For Osteoarthritis In Chile ePoster Presentation Maximiliano Andres Barahona, MD, MSc, CHILE Cristian Barrientos, MD, CHILE Alvaro Martinez, MD, CHILE Julian Brañes, MD, CHILE Juan Pablo Prieto, MD, CHILE Jaime Hinzpeter, MD, CHILE
Assessing The Risk Of Osteoarthritis Progression And Femoral Head Collapse Following Hip Corticosteroid/Anesthetic Injection Abstract Presentation 5 minutes Paul F Abraham, BS, UNITED STATES Nathan Varady, MD, MBA, UNITED STATES Kirstin Small, MD, UNITED STATES Nehal Shah, MD, UNITED STATES Luis S Beltran, MD, UNITED STATES Michael Peter Kucharik, BS, UNITED STATES Christopher T Eberlin, BS, UNITED STATES Wendy Madeline Meek, BBA, UNITED STATES Scott D Martin, MD, UNITED STATES
Covid Mortality Among Neck Of Femur Fractures During The Pandemic 2019 Abstract Presentation 5 minutes Aashish Raghu, MBBS, MS, MRCS, FRCS (Tr & Orth), UNITED KINGDOM Anas Hassan, MBBS, MRCS, UNITED KINGDOM Nicholas Dr Roeck, MB ChB, FRCS (ENG), FRCS (Tr&Orth), UNITED KINGDOM Mohamed Antar, MBBS, Master of Orthopaedics, MRCS, UNITED KINGDOM
Assessing Risk Of Osteonecrosis Of The Hip Following Intraarticular Injections: Hyaluronic Acid Versus Corticosteroid Abstract Presentation 5 minutes Nathan Varady, MD, MBA, UNITED STATES Ahab Chopra, BA, UNITED STATES Paul F Abraham, BS, UNITED STATES Michael Peter Kucharik, BS, UNITED STATES Christopher T Eberlin, BS, UNITED STATES David Freccero, MD, UNITED STATES Eric L. Smith, MD, UNITED STATES Scott D Martin, MD, UNITED STATES
Efficacy Of Tranexamic Acid In Hip Fracture Surgeries ePoster Presentation Aabid Sanaullah, MBBS,MRCS,MRCPS,PGDipTrauma Surg.FEBOT,FRCSTr&Orth, UNITED KINGDOM Adeel Nawab Ditta, MBBS, MRCS, UNITED KINGDOM Olufunso Damilare Onayemi, MRCS MCH (Ortho), UNITED KINGDOM Ahsan Sheeraz, BSc MBBS MRCS, UNITED KINGDOM Atif A. Malik, MB ChB, MRCS Ed, MSc. (Orto. Eng), FRCS Tr & Orth, UNITED KINGDOM
Evaluation of endoscopically gluteus medius repair in patients with Femoro-acetabular impingement and labrum detachment ePoster Presentation George D. Tsikouris, MD, GREECE Nikolaos D. Gravvanis, MD, GREECE Georgia S. Dedousi, MD, GREECE Panagiota Vlaserou, BSc in Physiotherapy, MSc Biomedical Engineer, GREECE Fanis P. Papadakis, BSc, MSc(cand.), GREECE Ioannis K. Antonopoulos, GREECE Vassilis N. Psychoyios, MD, GREECE Theodoros G. Troupis, Prof, GREECE
Long Term Outcomes After Arthroscopic Treatment Of Femoroacetabular Impingement For Patients With Borderline Dysplasia Abstract Presentation 4 minutes Ryan S. Selley, MD, UNITED STATES Molly A Day, MD, UNITED STATES Reena Olsen, BS, UNITED STATES Stephanie S Buza, MD, UNITED STATES Bryan T. Kelly, MD, UNITED STATES Anil S. Ranawat, MD, UNITED STATES Danyal H. Nawabi, MD, FRCS(Orth), UNITED STATES

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Outcomes of Associated Both Column Acetabular Fractures with and without a Posterior Wall Fracture

Outcomes of Associated Both Column Acetabular Fractures with and without a Posterior Wall Fracture

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Outcomes of Associated Both Column Acetabular Fractures with and without a Posterior Wall Fracture

Outcomes of Associated Both Column Acetabular Fractures with and without a Posterior Wall Fracture

Background

Results

Conclusion

More ISAKOS 2021: Global Content