Total hip arthroplasty for posttraumatic osteoarthritis following acetabular fracture: A systematic review of characteristics, outcomes, and complications / 中华创伤杂志(英文版)

<p><b>PURPOSE</b>Posttraumatic arthritis (PTA) may develop years after acetabular fracture, hindering joint function and causing significant chronic musculoskeletal pain. Given the delayed onset of PTA, few studies have assessed outcomes of delayed total hip arthroplasty (THA) in acetabular fracture patients. This study systematically reviewed the literature for outcomes of THA in patients with PTA and prior acetabular fracture.</p><p><b>METHODS</b>Pubmed, EMBASE, SCOPUS, and Cochrane library were searched for articles containing the keywords "acetabular", "fracture", "arthroplasty", and "post traumatic arthritis" published between 1995 and August 2017. Studies with less than 10 patients, less than 2 years of follow-up, conference abstracts, and non-English language articles were excluded. Data on patient demographics, surgical characteristics, and outcomes of delayed THA, including implant survival, complications, need for revision, and functional scores, was collected from eligible studies.</p><p><b>RESULTS</b>With 1830 studies were screened and data from 10 studies with 448 patients were included in this review. The median patient age on date of THA was 51.5 years, ranging from 19 to 90 years. The median time from fracture to THA was 37 months, with a range of 27-74 months. Mean follow-up times ranged from 4 to 20 years. The mean Harris hip scores (HHS) improved from 41.5 pre-operatively, to 87.6 post-operatively. The most prevalent postoperative complications were heterotopic ossification (28%-63%), implant loosening (1%-24%), and infection (0%-16%). The minimum 5-year survival of implants ranged from 70% to 100%. Revision rates ranged from 2% to 32%.</p><p><b>CONCLUSION</b>Despite the difficulties associated with performing THA in patients with PTA from previous acetabular fracture (including soft tissue scarring, existing hardware, and acetabular bone loss) and the relatively high complication rates, THA in patients with PTA following prior acetabular fracture leads to significant improvement in pain and function at 10-year follow-up. Further high quality randomized controlled studies are needed to confirm the outcomes after delayed THA in these patients.</p>

Total Knee Arthroplasty for Posttraumatic Arthritis : Comparison of the Results with Primary Degenerative Osteoarthritic Patients

PURPOSE: To compare the results of a total knee arthroplasty (TKA) between the degenerative osteoarthritic patients and the posttraumatic arthritic patients. MATERIALS AND METHODS: 38 cases with posttraumatic arthritis (group A) and 40 cases with degnerative osteoarthritis (group B) had a total knee arthroplasty between April 1995 and May 2002. The knee score, functional score, activity level and radiologic analyses were performed. RESULTS: There were no significant difference in the knee score, functional score, activity level and radiological findings between the two groups. The range of motion arcs were reduced in the posttraumatic arthritic patients. There is a higher complication rate in the post-traumatic arthritic patients (36%) when compared with the degenerative osteoarthritic patients (15%) after TKA . CONCLUSION: In group A showed a higher complication rate and reduced range of motion arcs. However, in terms of our results, we considered that a total knee arthroplasty is an useful treatment for the posttraumatic arthritis in spite of the technical difficulties.

Ankle Arthrodesis Using the Transfibular Approach / 대한정형외과학회잡지

PURPOSE: We analyzed the clinical and radiological results of transfibular ankle arthrodesis for posttraumatic arthritis. MATERIALS AND METHODS: Eighteen cases of transfibular ankle arthrodesis were followed for more than 12 months postoperatively. Mean age was 55 years, and the mean follow-up period was 2.9 years. Preoperative and postoperative AOFAS ankle-hindfoot scores, operative times, postoperative complications and patients satisfaction level were checked. Radiologically preoperative ankle deformity, time to union, position of fusion, residual tarsal motion arc and degenerative changes of adjacent foot joints were evaluated. RESULTS: At the last follow-up, the mean AOFAS ankle-hindfoot score had increased from a preoperative 41 points to 79 points. Sixteen patients (89%) were satisfied with the result. The mean operative time was 108 minutes. Three cases of chronic tear of the peroneus brevis tendon were treated. Mean time to radiological union was 13.1 weeks. No degenerative changes in adjacent foot joints were observed at the last follow up. Two cases (11%) of nonunion and one case (5.5%) of delayed union were observed. Revision of arthrodesis was performed in one case of nonunion. CONCLUSION: Satisfactory results were obtained after transfibular ankle arthrodesis for posttraumatic arthritis. Long-term follow up is needed to evaluate the effects of ankle arthrodesis upon adjacent foot joints.