title: Acetabular fractures: the role of total hip replacement.
abstract: Total hip replacement (THR) after acetabular fracture presents unique challenges to the orthopaedic surgeon. The majority of patients can be treated with a standard THR, resulting in a very reasonable outcome. Technical challenges however include infection, residual pelvic deformity, acetabular bone loss with ununited fractures, osteonecrosis of bone fragments, retained metalwork, heterotopic ossification, dealing with the sciatic nerve, and the difficulties of obtaining long-term acetabular component fixation. Indications for an acute THR include young patients with both femoral head and acetabular involvement with severe comminution that cannot be reconstructed, and the elderly, with severe bony comminution. The outcomes of THR for established post-traumatic arthritis include excellent pain relief and functional improvements. The use of modern implants and alternative bearing surfaces should improve outcomes further.
authors.affiliation: Mayo Clinic, Department of Orthopaedic Surgery, 200 First St, SW, Rochester, Minnesota 55905, USA.
authors.forename: R J
authors.initials: RJ
authors.lastname: Sierra
authors.forename: T M
authors.initials: TM
authors.lastname: Mabry
authors.forename: S A
authors.initials: SA
authors.lastname: Sems
authors.forename: D J
authors.initials: DJ
authors.lastname: Berry
mesh_terms: D000077:Acetabulum / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery*; D019644:Arthroplasty, Replacement, Hip / Q000295:instrumentation / Q000379:methods*; D005471:Fluoroscopy; D005547:Foreign Bodies / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery; D018460:Fractures, Comminuted / Q000000981:diagnostic imaging / Q000601:surgery; D005599:Fractures, Ununited / Q000000981:diagnostic imaging / Q000601:surgery; D006620:Hip Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D006622:Hip Prosthesis; D006801:Humans; D009999:Ossification, Heterotopic / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery; D015207:Osteoarthritis, Hip / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery; D010020:Osteonecrosis / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery; D010388:Pelvis / Q000002:abnormalities / Q000000981:diagnostic imaging; D011474:Prosthesis Design; D019651:Plastic Surgery Procedures / Q000295:instrumentation / Q000379:methods*; D012307:Risk Factors
keywords: Acetabular reconstruction; Acute THR; Arthroplasty; Autograft bone; THR; acetabular fracture