Ranawat Anil, Zelken Jonathan, Helfet David, Buly Robert
The Hospital for Special Surgery, New York, New York, USA.
J Arthroplasty. 2009 Aug;24(5):759-67. doi: 10.1016/j.arth.2008.04.004. Epub 2008 Jun 4.
Total hip arthroplasty (THA) outcomes for posttraumatic arthritis after acetabular fracture have yielded inferior results compared to primary nontraumatic THA. Recently, improved results have been demonstrated using cementless acetabular reconstruction. Thirty-two patients underwent THA for posttraumatic arthritis after acetabular fracture; 24 were treated with open reduction internal fixation, and 8 were managed conservatively. Time from fracture to THA was 36 months (6-227 months). Average follow-up was 4.7 years (2.0-9.7 years). Harris Hip score increased from 28 (0-56) to 82 points (20-100). Six patients required revision. Five-year survival with revision, loosening, dislocation, or infection as an end point was 79%. Survival for aseptic acetabular loosening was 97%. Revision surgery correlated with nonanatomic restoration of the hip center and a history of infection (P < .05). Despite obvious challenges, advances in fracture management and cementless acetabular fixation in THA demonstrate improved results for posttraumatic arthritis following acetabular fracture.
与初次非创伤性全髋关节置换术（THA）相比，髋臼骨折后创伤性关节炎行THA的结果较差。最近，使用非骨水泥髋臼重建已显示出改善的结果。32例髋臼骨折后创伤性关节炎患者接受了THA；24例接受切开复位内固定治疗，8例采用保守治疗。从骨折到THA的时间为36个月（6 - 227个月）。平均随访4.7年（2.0 - 9.7年）。Harris髋关节评分从28分（0 - 56分）提高到82分（20 - 100分）。6例患者需要翻修。以翻修、松动、脱位或感染为终点的5年生存率为79%。无菌性髋臼松动的生存率为97%。翻修手术与髋关节中心的非解剖学复位及感染史相关（P < 0.05）。尽管存在明显挑战，但THA中骨折处理和非骨水泥髋臼固定技术的进步表明，髋臼骨折后创伤性关节炎的治疗结果有所改善。
