Zhang Bin-Fei, Zhuang Yan, Liu Lin, Xu Ke, Wang Hu, Wang Bo, Wen Hong-Quan, Xu Peng
Department of Joint Surgery, Honghui Hospital, Xi'an Jiaotong University, Xi'an, China.
Department of Orthopaedic Trauma, Honghui Hospital, Xi'an Jiaotong University, Xi'an, China.
Front Surg. 2023 Jan 6;9:1063469. doi: 10.3389/fsurg.2022.1063469. eCollection 2022.
Older patient population with acetabular fractures is increasing rapidly, requiring enhanced recovery. Acute total hip arthroplasty (THA) is a good option for these patients, and it is becoming increasing popular. However, acute THA has different indications in different studies. Therefore, a systematic review is needed to assess and comprehend the indications for acute THA in older patients.
A systematic literature review was conducted to identify a retrospective series or prospective studies in older patients (>60 years) with acetabular fractures. The search timeline was from database construction till December 2021; PubMed, Embase, and Cochrane Library databases were searched. Two trained professional reviewers independently read the full text of documents that met the inclusion criteria and extracted information on the specific methods used and indication information based on the research design.
In total, there were 601 patients with acetabular fractures aged >60 years from 33 studies were obtained. Twenty-eight studies reported that THA was a feasible treatment option for acetabular fractures in geriatric patients with good outcome. The primary indications were dome impaction, irreducible articular comminution, femoral head injury, and pre-existing osteoarthritis or avascular necrosis. The most common patterns were anterior column and posterior hemitransverse, posterior wall, both columns, and T-type.
Acute THA is an effective treatment strategy for older patients with acetabular fractures and should be considered when the abovementioned indications are observed on preoperative images. (PROSPERO: CRD42022329555).
老年髋臼骨折患者数量正在迅速增加，需要加快康复进程。急性全髋关节置换术（THA）对这些患者来说是一个不错的选择，并且越来越受欢迎。然而，在不同的研究中急性THA有不同的适应症。因此，需要进行一项系统评价来评估和理解老年患者急性THA的适应症。
进行了一项系统的文献综述，以确定关于老年（>60岁）髋臼骨折患者的回顾性系列研究或前瞻性研究。检索时间范围为从数据库建立至2021年12月；检索了PubMed、Embase和Cochrane图书馆数据库。两名经过培训的专业评审员独立阅读符合纳入标准的文献全文，并根据研究设计提取所使用的具体方法和适应症信息。
总共从33项研究中获得了601例年龄>60岁的髋臼骨折患者。28项研究报告称，THA是老年髋臼骨折患者可行的治疗选择，效果良好。主要适应症为髋臼顶撞击、关节面粉碎性骨折无法复位、股骨头损伤以及既往存在骨关节炎或缺血性坏死。最常见的骨折类型为前柱和后半横行、后壁、双柱和T型。
急性THA是老年髋臼骨折患者的一种有效治疗策略，当术前影像出现上述适应症时应予以考虑。（国际前瞻性系统评价注册库：CRD42022329555）
