The treatment of traumatic osteoarthritis resulting from acetabular fractures / 中华骨科杂志

ABSTRACT

Objective To evaluate the clinical treatments and results of traumatic osteoarthritis of the hip joint after acetabular fracture. Methods One hundred and seven patients with acetabular fractures admitted from March 1995 to December 2003 were reviewed. Twenty-five cases of traumatic osteoarthritis were found during an average follow up of 2.5 years (8 month to 5.5 years). There were 18 male and 7 female with an average age of 42.7 years (28 to 71). According to Letournel classification, there were anterior-column fractures in 3 patients, anterior-wall in 2, posterior column in 3, posterior wall in 6, posterior wall and column in 3, transvers combined posterior wall in 5, and both-column in 1 patients. The operative related complication of heterotopic ossification was found in 6 , and bone defect in 3 patients. The pathological changes ofⅠ-stage was in 4,Ⅱ-stage in 5, Ⅲ-stage in 10,Ⅳ-stage in 5, and Ⅴ-stage in 1 patient. The mean Harris score of these patients was 52.6 points. Fourteen cases of traumatic osteoarthritis were treated with conservative treatment and 11 cases with total hip arthroplasty. Results Fourteen patients with conservative treatment were followed up 16 months in average (8 to 30 months) .The symptom of traumatic osteoarthritis in 12 cases had improved with the same initial radiographic findings and 2 cases deteriorated with narrowing of the joint space and hyperplasia. The latest mean Harris score for these patients was 61.8 points in average. Eleven patients with total hip arthroplasty were followed up for an average of 32 months(13 to 60 months) and the latest mean Harris score was 87.6 points in average. There were no complications related to the surgery occurred. Conclusion The traumatic osteoarthritis of acetabular fractures after operation is relative higher. The quality of reduction is an important factor influencing the long-term results of acetabular fractures and resulting traumatic osteoarthritis. For the patients with Ⅰ to Ⅲ-stage of pathological changes, conservertive treatment may obtain a relative good results. For the Ⅳ to Ⅴ-stage, total hip arthroplasty can gain an early satisfactory results.