Acetabular fracture: Long-term follow-up and factors associated with secondary implantation of total hip arthroplasty

Hypothesis: The present study sought to determine long-term outcome in acetabular fracture and the factors associated with secondary implantation of a total hip arthroplasty and/or with poor functional results. Material and methods: Seventy-two patients admitted between 2000 and 2005 were followed up for a maximum 11 years (mean, 6.8 years): 16 females, 56 males; mean age at injury, 41.6 years (median, 40 years). There were 45 simple acetabular fractures, 27 complex fractures and 27 dislocations. Late complications were: osteoarthritis (n = 29), osteonecrosis of the femoral head (ONFH: n = 8) and heterotopic ossification (n = 2). Results and discussion: Twenty-five total hip arthroplasties (THA) were performed, with a mean time to surgery of 3.7 years. Associated factors for THA were: VAS (P < 0.0001), PMA (P < 0.0001), osteoarthritis (P < 0.0001), ONFH (P < 0.0002), initial dislocation (P = 0.0002), no functional treatment (P = 0.0014), surgical treatment (P = 0.0065), initial traction (P = 0.0068), anterior and posterior congruency defect (P = 0.0072 and P < 0.0001), and initial intra-articular foreign body (P = 0.045). Factors associated with poor or bad functional results were the same, plus: etiology (P = 0.0021), BMI (P = 0.03) and posterior wall fracture (P = 0.0325).