title: Treatment of periprosthetic acetabular fractures after previous hemi- or total hip arthroplasty: Introduction of a new implant.
abstract: OBJECTIVE
  Treatment of displaced periprosthetic acetabular fractures in elderly patients. The goal is to stabilize an acetabular fracture independent of the fracture pattern, by inserting the custom-made roof-reinforcement plate and starting early postoperative full weight-bearing mobilization.
  
  
  METHODS
  Acetabular fracture with or without previous hemi- or total hip arthroplasty.
  
  
  METHODS
  Non-displaced acetabular fractures.
  
  
  METHODS
  Watson-Jones approach to provide accessibility to the anterior and supraacetabular part of the iliac bone. Angle-stable positioning of the roof-reinforcement plate without any fracture reduction. Cementing a polyethylene cup into the metal plate and restoring prosthetic femoral components.
  
  
  METHODS
  Full weight-bearing mobilization within the first 10 days after surgery. In cases of two column fractures, partial weight-bearing is recommended.
  
  
  RESULTS
  Of 7 patients with periprosthetic acetabular fracture, 5 were available for follow-up at 3, 6, 6, 15, and 24 months postoperatively. No complications were recognized and all fractures showed bony consolidation. Early postoperative mobilization was started within the first 10 days. All patients except one reached their preinjury mobility level. This individual and novel implant is custom made for displaced acetabular and periprosthetic fractures in patients with osteopenic bone. It provides a hopeful benefit due to early full weight-bearing mobilization within the first 10 days after surgery.
  
  
  CONCLUSIONS
  In case of largely destroyed supraacetabular bone or two-column fractures according to Letournel additional synthesis via an anterior approach might be necessary. In these cases partial weight bearing is recommended.
authors.affiliation: Department of Trauma Surgery and Sports Injuries, Paracelsus Medical University, Muellner Hauptstr. 48, A-5020, Salzburg, Austria. herbert.resch@pmu.ac.at.
authors.forename: H
authors.initials: H
authors.lastname: Resch
authors.affiliation: Department of Trauma Surgery, Medical University Innsbruck, Innsbruck, Austria.
authors.forename: D
authors.initials: D
authors.lastname: Krappinger
authors.affiliation: Department of Trauma Surgery and Sports Injuries, Paracelsus Medical University, Muellner Hauptstr. 48, A-5020, Salzburg, Austria.
authors.forename: P
authors.initials: P
authors.lastname: Moroder
authors.affiliation: Department of Trauma Surgery, Medical University Innsbruck, Innsbruck, Austria.
authors.forename: M
authors.initials: M
authors.lastname: Blauth
authors.affiliation: Department of Trauma Surgery and Sports Injuries, Paracelsus Medical University, Muellner Hauptstr. 48, A-5020, Salzburg, Austria.
authors.forename: J
authors.initials: J
authors.lastname: Becker
mesh_terms: D000077:Acetabulum / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery*; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip; D019544:Equipment Failure Analysis; D005260:Female; D005593:Fracture Fixation, Internal / Q000295:instrumentation* / Q000379:methods; D017102:Fracture Healing; D006622:Hip Prosthesis; D006801:Humans; D008297:Male; D057068:Periprosthetic Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D011474:Prosthesis Design; D012086:Reoperation / Q000295:instrumentation / Q000379:methods; D016896:Treatment Outcome
keywords: Acetabulum; Mobilization; Osteoporosis; Prosthesis; Weight-bearing