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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No Difference In Minimum Two-Year Patient-Reported Outcome Scores Between Circumferential And Segmental Labral Reconstruction For The Management Of Irreparable Labral Tear And Femoroacetabular Impingement Syndrome In The Primary Setting. ePoster Presentation David R. Maldonado, MD, UNITED STATES Cynthia Kyin, BA, UNITED STATES Jacob Shapira, MD, UNITED STATES Mitchell Meghpara, MD, UNITED STATES Philip Joseph Rosinsky, MD, UNITED STATES Ajay C. Lall, MD, MS, FAAOS, UNITED STATES Benjamin G. Domb, MD, UNITED STATES
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Risk Of Conversion To Arthroplasty Following Hip Arthroscopy: Validation Of A Published Risk Score Using An Independent, Prospectively Collected Database Abstract Presentation 4 minutes Mario Hevesi, MD, PhD, UNITED STATES Devin Leland, MD, UNITED STATES Philip Joseph Rosinsky, MD, UNITED STATES Ajay C. Lall, MD, MS, FAAOS, UNITED STATES Benjamin G. Domb, MD, UNITED STATES David E. Hartigan, MD, UNITED STATES Bruce A. Levy, MD, UNITED STATES Aaron J. Krych, MD, UNITED STATES
A Systematic Review Of Terminology, Surgical Techniques, Preoperative Diagnostic Measures, And Geographic Differences In The Treatment Of Athletic Pubalgia/Sports Hernia/Core Muscle Injury/Inguinal Disruption ePoster Presentation Matthew J. Kraeutler, MD, UNITED STATES Omer Mei-Dan, MD, UNITED STATES John W. Belk, BA, UNITED STATES Christopher M. Larson, MD, UNITED STATES Toghrul Talishinskiy, MD, UNITED STATES Anthony Scillia, UNITED STATES
Arthroscopic Tendon Release for Iliopsoas Impingement after Total Hip Arthroplasty ePoster Presentation Michael Andreas Finsterwald, MD, AUSTRALIA Georgina Waters, MD, AUSTRALIA Jay R. Ebert, PhD, AUSTRALIA Christopher W. Jones, FAOrthA FRACS PhD MBBS(Hons) BEng(Hons) BCom, AUSTRALIA Piers Yates, MBBS(Hons) BSc(Hons) MRCS(Eng) FRCS(Tr & Orth) FRA, AUSTRALIA Peter Alberto D'Alessandro, MBBS Hons. (UWA) FRACS FAOrthA, AUSTRALIA
Can BMAC Application Safely Diminish Perioperative Pain In Patients Undergoing Hip Arthroscopy? Abstract Presentation 5 minutes Michael Peter Kucharik, BS, UNITED STATES Paul F Abraham, BS, UNITED STATES Mark R. Nazal, MPH, UNITED STATES Nathan Varady, MD, MBA, UNITED STATES Wendy Madeline Meek, BBA, UNITED STATES Stephen M Gillinov, AB, UNITED STATES Christopher T Eberlin, BS, UNITED STATES Scott D Martin, MD, UNITED STATES
Radiographic Indices Are Not Predictive Of Clinical Outcome Among 1,735 Patients Indicated For Hip Arthroscopy: A Machine Learning Analysis Abstract Presentation 5 minutes Prem N Ramkumar, MD, MBA, UNITED STATES Jaret M Karnuta, MS, UNITED STATES Heather S Haeberle, MD, UNITED STATES Spencer Sullivan, BS, UNITED STATES Danyal H. Nawabi, MD, FRCS(Orth), UNITED STATES Anil S. Ranawat, MD, UNITED STATES Bryan T. Kelly, MD, UNITED STATES Benedict U. Nwachukwu, MD, MBA, UNITED STATES
Can Hip Microinstability Be Predicted By Hip Range Of Motion Abstract Presentation 5 minutes Marc R. Safran, MD, Prof., UNITED STATES Justin Hopkins, MD, UNITED STATES Katia Elisman, BS, UNITED STATES Andrea Finlay, PhD, UNITED STATES Nicole Segovia Pham, MPH, UNITED STATES
Endoscopic Shelf Acetabuloplasty Concomitant With Labral Repair, Cam Osteoplasty, And Capsular Plication For Treating Artistic Dancers In The Setting Of Acetabular Dysplasia: A Case Series Abstract Presentation 4 minutes Soshi Uchida, MD, PhD, JAPAN Yoichi Murata, MD, JAPAN Hajime Utsunomiya, MD, PhD, JAPAN Tsukamoto Manabu, MD, PhD, JAPAN Akihisa Hatakeyama, MD, JAPAN Shiho Kanezaki, MD, PhD, JAPAN Akinori Sakai, MD, PhD, JAPAN
Natural History Of Femoroacetabular Impingement: Using Machine Learning To Evaluate Risk Factors For Osteoarthritis In A Large Geographic Population Over The Long-Term Abstract Presentation 5 minutes Ayoosh Pareek, MD, UNITED STATES Sunho Ko, MD, KOREA, NORTH Heath Melugin, MD, UNITED STATES Changwung Jo, MD, KOREA, REPUBLIC OF Ryan R Wilbur, BS, UNITED STATES Bryant M. Song, MS, UNITED STATES Aaron J. Krych, MD, UNITED STATES
Hip Arthroscopic Portals:A New Approach Through Accessory Portals Established Within 3Cm Around Anterolateral Portal ePoster Presentation Kiran Kumar Shah, MD, NEPAL
Effect Of Femoral And Acetabular Version On Outcomes Following Hip Arthroscopy: A Systematic Review And Meta-Analysis Abstract Presentation 9 minutes Casey Wang, MD, CANADA Dan Cohen, MD, CANADA Jeffrey Kay, MD, CANADA Mahmoud Almasri, MD, FRCSC, UNITED STATES Nicole Simunovic, MSc, CANADA Carlomagno Cardenas-Nylander, MD, SPAIN Anil S. Ranawat, MD, UNITED STATES Olufemi R. Ayeni, MD, PhD, MSc, FRCSC, CANADA
Stem Cells Injection And Percutaneous Femoral Head Decompression - An Extremely Rare Procedure With Good Results ePoster Presentation Sofia Moura De Carvalho, MD, PORTUGAL Inês Domingues, MD, PORTUGAL Liliana Domingues, MD, PORTUGAL Eduardo Ramalho Silva, MD, PORTUGAL Gonçalo Lavareda, MD, PORTUGAL Filipe Machado, MD, PORTUGAL Rita Ricardo, MD, PORTUGAL
Midterm Outcomes Following Hip Labral Augmentation Abstract Presentation 4 minutes Joseph J. Ruzbarsky, MD, UNITED STATES Rui Soares, BS, UNITED STATES Justin W. Arner, MD, UNITED STATES Lauren Pierpoint, PhD, UNITED STATES Maitland Martin, BS, UNITED STATES Spencer M Comfort, BS, UNITED STATES Marc J. Philippon, MD, UNITED STATES
Arthroscopy For Gunshot Wounds To The Hip ePoster Presentation Jorge Figueras, BS, UNITED STATES J P Ertl, MD, UNITED STATES Karchi Ertl, BS, UNITED STATES Brian Mullis, MD
Correlation Between Arthro-MRI Results And Intraoperative Hip Arthroscopy Findings In Fai Syndrome ePoster Presentation Christian Sobau, MD, GERMANY Konstantinos Tramountanis, MD, GERMANY Wolfgang Miehlke, MD, GERMANY Alexander Zimmerer, MD, GERMANY

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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