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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Can Intra-Articular Gadolinium Confound The Results Of A Diagnostic Anesthetic Injection In Young Patients With Hip Pain? Abstract Presentation 5 minutes Daniel Curtis, MD, UNITED STATES William Michael Pullen, MD, UNITED STATES Christopher Jamero, MA, ATC, UNITED STATES Marc R. Safran, MD, Prof., UNITED STATES
Female Athletes Demonstrate Greater Improvement in Patient Reported Outcome Scores and Equal Return To Sport Rates Compared to Males After Hip Arthroscopy A Gender Based Matched Comparison of High-Level Athletes Abstract Presentation 4 minutes Andrew Jimenez, MD, UNITED STATES Rachel Glein, BS, UNITED STATES Kara Miecznikowski, BS, UNITED STATES Benjamin Saks, MD, UNITED STATES Hari Krishna Ankem, MD, UNITED STATES Payam William Sabetian, MD, GUATEMALA Benjamin G. Domb, MD, UNITED STATES
EVALUATION OF HIP ARTHROSCOPY IN ELITE ATHLETES WITHOUT HIP DYSPLASIA . OUR EXPERIENCE. A 15-YEAR STUDY ePoster Presentation George D. Tsikouris, MD, GREECE Nikolaos D. Gravvanis, MD, GREECE Georgia S. Dedousi, MD, GREECE Ioannis K. Antonopoulos, GREECE Fanis P. Papadakis, BSc, MSc(cand.), GREECE Demetrios P. Tsikouris, PT, GREECE Eleftherios Tsikouris, BSc in Physiotherapy, GREECE Theodoros G. Troupis, Prof, GREECE
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
The Radiographical Influence Of Torsional Deformity Of The Acetabular And Femur In Dysplastic Hips ePoster Presentation Carsten Heimer, BA, GERMANY Carsten Perka, MD, PhD, GERMANY Henrik Baecker, MD, GERMANY
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
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
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
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
Risk Factors For Early Conversion To Hip Arthroplasty Following Hip Arthroscopy: A Matched Cohort Analysis Abstract Presentation 4 minutes Joseph J. Ruzbarsky, MD, UNITED STATES Max Seiter, MD, UNITED STATES Rui Soares, BS, UNITED STATES Lauren Pierpoint, PhD, UNITED STATES Karen K. Briggs, MPH, MBS, UNITED STATES Marc J. Philippon, MD, UNITED STATES
Efficacy Of Enoxaparin As A Thromboprophylactic Agent In Major Lower Limb Orthopedic Surgeries. ePoster Presentation Raghavendra Raju, MBBS,MS, INDIA Prasad Soraganvi, MBBS, MS, DNB, MRCS, SICOT-dip, INDIA
Cannabis Use Is Not Associated With Increased Opioid Use Or Costs After Hip Arthroscopy Abstract Presentation 5 minutes Christopher L. McCrum, MD, UNITED STATES Jacob Thomas Wood, BS, UNITED STATES Senthil Sambandam, MD, UNITED STATES
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
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
Promis Mobility: Evaluation Of The Lower Extremity-Specific Instrument In A Sports Medicine Hip Registry ePoster Presentation Molly A Day, MD, UNITED STATES Ryan S. Selley, MD, UNITED STATES Kyle Hancock, MD, UNITED STATES Reena Olsen, BS, UNITED STATES Danyal H. Nawabi, MD, FRCS(Orth), UNITED STATES Benedict U. Nwachukwu, MD, MBA, UNITED STATES Stephanie S Buza, MD, UNITED STATES Anil S. Ranawat, MD, UNITED STATES Bryan T. Kelly, MD, 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